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Repeat HIV Testing Improves Detection During Pregnancy

Rapid test at delivery recommended in high prevalence areas

MONDAY, Aug. 27 (HealthDay News) -- Repeat testing for HIV during pregnancy increases opportunities for use of antiretroviral prophylaxis, particularly in high-prevalence areas in which women may seroconvert after an initial HIV-negative test, according to a report in the August issue of the American Journal of Obstetrics & Gynecology.

Steven Nesheim, M.D., of Emory University School of Medicine in Atlanta, and colleagues used data from the Mother-Infant Rapid Intervention at Delivery study, sponsored by the U.S. Centers for Disease Control and Prevention, which encouraged repeat HIV testing during pregnancy in six U.S. cities.

The study identified 54 HIV-positive women, of whom four had primary infections with median estimated seroconversion at 22 weeks of pregnancy. All four women denied use of alcohol, illegal drugs or having new sex partners during pregnancy. Of these four, three mother-infant pairs received antiretroviral medications. One of the infants became infected at birth. Two more women were identified as HIV-positive through rapid testing at labor and delivery.

"Ideally, repeat testing should be done during routine prenatal care in the third trimester," the authors conclude. "Repeat testing late in pregnancy or at labor and delivery does identify recent infection. To provide timely care for the infant whose mother's status is uncertain, a rapid HIV test should be used in labor and delivery."

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