Indian Journal of Medical Microbiology Medknow Publications on behalf of Indian Association of Medical Microbiology ISSN: 0255-0857 EISSN: 1998-3646 Vol. 25, Num. 2, 2007, pp. 172-173

Indian Journal of Medical Microbiology, Vol. 25, No. 2, April-June, 2007, pp. 172-173

Correspondence

Prevalence of Human Immunodeficiency Virus infection in pregnant women

M Mustafa, KS Ahmed, CM Habibullah

Princess Esra Hospital and Owaisi Hospital, Hyderabad - 500 076, Andhra Pradesh

Correspondence Address:Princess Esra Hospital and Owaisi Hospital, Hyderabad - 500 076, Andhra Pradesh, India (email: khajashakeel@gmail.com)

Date of Submission: 13-Nov-2006
Date of Acceptance: 06-Dec-2006

Code Number: mb07051

Dear Editor,

Large scale antenatal surveys for the prevalence of human immunodeficiency virus ( HIV) infection have been conducted in Europe, USA and some countries of Africa. ^[1],[2] This problem has also been studied by some workers in India. ^[3],[4],[5] However, there is a paucity of data regarding seroprevalence in different parts of this country. This study presents the results of HIV screening of pregnant women in Hyderabad region during the last five years. Pregnant women undergoing antenatal care or medical termination of pregnancy at Princess Esra Hospital and Owaisi Hospital in Hyderabad were screened for the presence of anti HIV antibodies in last six years (July 2001- July 2006). The testing was based on an unlinked and anonymous screening strategy.

The initial screening was done by comb AIDS. Tridot and EIA were used as supplementary tests on all positive cases. The tests were performed as per the manufacturer′s instructions and recommendations of national AIDS control organization (NACO). Serum was subjected once to E/R/S for HIV. If negative, the serum was considered free of HIV and if positive, the sample was considered HIV infected. This is similar to strategy one with respect to donor blood utilization in blood banks. The unit of blood testing positive is discarded.

With respect to surveillance, the serum is considered negative for HIV if the first ELISA report is negative, but if reactive, it is subjected to a second ELISA test, which utilizes a system different than the first one. It is reported reactive only if the second ELISA confirms the report. This strategy is used for diagnosis only if some AIDS indicator disease is present. It is similar to strategy two with the added confirmation of a third reactive ELISA test being required for a sample to be reported HIV positive. The test to be utilized for the first ELISA is one with the highest sensitivity and for the second and third ELISAs, tests with the highest specificity are to be used. Strategy two and three are used for diagnosis of HIV infection. ELISA 2 and ELISA 3 ought to be tests with the highest positive predictive value possible to eliminate any chance of false positive results. Strategy three is used to diagnose HIV infection in asymptomatic individuals indulging is high-risk behavior.

The results of this study show the number of women tested for HIV antibody during 2001 to 2006 to be 10. The table shows the number of patients tested over the years.

These women were found to be reactive by all three strategies. HIV was practically absent during 2001 and 2002 in the study group. It showed a slow but steady increase thereafter. By the end of 2003 up to 0.5 per thousand of these women had serological evidence of infection by HIV-1. During 2004 and 2006 the seropositivity rose to 0.8, 1.0 and 1.1 per thousand respectively. The women were between 20-40 years of age and belonged to low socioeconomic status. Three of the HIV positive women were primigravida and three were second gravida and remaining four were multigravida and had opted for MTP [Table - 1].

The present study has shown that seropositivity rate increased from 0-1.1 per thousand in pregnant women in the period of five years. Similar rates (ranging from 1-5 per thousand) have been reported by ICMR in India. ^[3] A study at Vellore has reported a seropositivity rate of 0.4 to 1 per thousand in expectant mothers. ^[4] While studies conducted at Miraj and Bombay in Maharashtra and Manipur have reported a much higher seropositivity of 4.5, 2.5 and 0.8% respectively. ^[5]

Virtually all HIV infection that occur in children, are a consequence of vertical transmission (that is, from mother to child), interruption of this mode of passage would change the future of AIDS in children. Routine HIV testing of all pregnant women is mandatory and strict universal biosafety precautions should be followed in providing obstetric and other patient care. Proper health education and counseling of seropositive mothers should be done.

References

Copyright 2007 - Indian Journal of Medical Microbiology

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