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[HIV screening in pregnancy--too many failures?]
Vibeke Rosenfeldt Nielsen1, Niels Henrik Valerius
1Børneafdeling 531, H:S Hvidovre Hospital, Kettegård Allé, DK-2650 Hvidovre. vrosenfeldt@dadlnet.dk
Ugeskrift for Laeger
|January 14, 2003
Summary
Selective HIV testing during pregnancy is ineffective. Universal HIV testing offers a better approach, as demonstrated by three infants with vertically acquired HIV infection born to mothers not offered testing despite high-risk factors.
Area of Science:
- Medical research
- Public health
- Infectious disease
Background:
- Danish guidelines recommend HIV testing for pregnant women in risk groups.
- Universal antenatal HIV testing is not mandated.
Observation:
- Three infants born within a year presented with AIDS-defining symptoms.
- Mothers belonged to high-risk groups (Thailand, Sub-Saharan Africa) but were not offered HIV tests.
- Infants developed Pneumocystis carinii pneumonia and severe failure to thrive.
Findings:
- Selective HIV screening during pregnancy is ineffective.
- Up to 20% of women with known risk factors may not be tested.
- Vertical HIV transmission occurred in these cases due to lack of testing.
Implications:
- Universal HIV testing offers a more effective strategy during antenatal care.
- Policy change is needed to ensure all pregnant women are offered HIV tests.
- Early detection and intervention can prevent pediatric AIDS-defining illnesses.