A protocol for routine voluntary antepartum human immunodeficiency virus antibody screening

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Citations from the Literature

immunodeIiciency virus (HIV) prevention. Methods: Of&based obstetricians-gynecologists in the Washington, DC metropolitan area who reported providing primary care were interviewed by telephone. The survey response rate was 62% (N = 268). Results: The percentages of obstetriciansgynecologists who reported regularly assessing the HIV risk of new adolescent and adult patients were 67 and 40%, respectively. Seventy-two percent reported regularly counseling patients at risk to use condoms for vaginal intercourse, and 60% regularly counseled patients at risk to limit their number of sexual partners. The level of general risk-factor assessment and contidence in the ability to reduce patients’ HIV risk were the strongest correlates of the frequency and thoroughness of HIV obstetricians-gynecologists who assess and counsel patients about HIV risks is below the 75% goal for the year 2000 established by the United States Department of Health and Human Services. Continuing medical education for obstetricians-gynecologists is needed to improve their knowledge and skills in HIV prevention. A protocol for routine vo11111tary notepartum human bnmunodeBciency vins antibody screenhtg Lindsay M.K. USA

AM J OBSTET GYNECOL 1993 168/2 (476-479) Human immunodeficiency virus infection among both women of reproductive age and their infants is rapidly increasing. One strategy to address this increase involves the offering of routine voluntary antepartum human immunodeficiency virus antibody counseling and testing. The rationale for this policy is that all prenatal patients are educated about the major modes of viral transmission and encouraged to practice risk reduction behavior. Human immunodeficiency virus-infected women receive comprehensive prenatal care; they are referred for medical follow-up, and their infants are identified and targeted for pediatric infectious disease follow-up. During the past 4 years we have developed a protocol for antepartum human immunodeficiency virus screening in our institution. The protocol includes a self-reported human immunodeIiciency virus risk behavior profile, pretest counseling conducted by trained human immunodeficiency virus counselors in small groups, written informed consent for human immunodeficiency virus antibody testing, posttest counseling, and education. By following this protocol we have identified and referred for followuP > 350 human immunodeticiency virus-infected women. Is HIV InfectIon associated with an increase in the prevalenceof cervical neoplasi~? Smith J.R.; Kitchen V.S.; Botcherby M.; Hepburn M.; Wells C.; Gor D.; Forster SM.; Harris J.R.W.; Steer P.; Mason P. GBR

BR J OBSTET GYNAECOL 1993 100/2 (149-153) Objective: To test the hypotheses: (1) that HIV infection predisposes to cervical intraepithelial neoplasia (CIN); (2) that this CIN is a result of HIV related immunosuppression; and (3) In1 J Gynecol Obstet 43

that this CIN is a result of immunosuppression causing increased expression of the potentially oncogenic viruses, human papilloma virus (HPV), Epstein Barr virus (EBV) and herpes simplex virus (HSV). Design: A matched cross sectional study. Setting: The Department of Gynaecological Oncology, The Samaritan Hospital, London; the Department of Genitourinary Medicine, St Mary’s Hospital, London; and the Family Planning Clinic, Claremont Terrace, Glasgow. Subjects: Fifty HIV seropositive women enrolled from the Genitourinary Medicine Department and the Drug Dependency Unit at St Mary’s Hospital, London, and the Unit of Infectious Diseases at Ruchill Hospital, Glasgow. Forty-three HIV seronegative controls enrolled from the Department of Genitourinary Medicine at St Mary’s Hospital, matched against 43 of the seropositive women for age, age at first intercourse, lifetime number of sexual partners, and smoking habit. Main outcome measures: Associations between CIN, as detected by cytology and histology, and HIV infection. Association was also sought between CIN and immunosuppression, as measured clincially by T4 cell number, &2microglobuhn and p24 antigen. Associations of these with: (1) HPV, as detected by Southern blot testing and the polymerase chain reaction; (2) EBV, as detected by Southern blot testing; and (3) HSV, as detected by tissue culture of endocervical swabs, was also studied. Results: There was no significant difference in the prevalence of CIN or oncogenic viruses between HIV seropositive and seronegative women in the absence of immunosuppression. If the HIV infected women showed signs of immunosuppression, the prevalence of CIN was increased. No association was shown between detection of HPV, EBV and HSV and immunosuppression of CIN. Conclusion: HIV infection may only be associated with an increased risk of CIN when immunosuppression is present. ‘H nuclear magnetic resonance studies of seminal plasma from fertile ad infertile men Hamamah S.; Seguin F.; Barthelemy C.; Akoka S.; Le Pape A.; Lansac J.; Royere D. FRA

J REPROD FERTIL 1993 97/l (51-55) Glycerylphosphorylcholine (GPC), glycerylphosphorylethanolamine (GPE), citrate, and lactate content of human seminal plasma was analyzed by measuring the peak area of ‘H nuclear magnetic resonance (NMR) spectra in samples from four groups of patients: 21 spermatogenic failure subjects; 14 obstructive axoospermic subjects (vasectomized); seven patients presenting very severe ohgoasthenozoospermia (OAT) and 18 normozoospetmic subjects (control). The peak areas for GPC, citrate and lactate in seminal plasma were significantly smaller for patients with azoospermia than for the control group: 16.79,8.18 and 2.28 versus 23.38, 10.58 and 4.30, respectively (P < 0.01). The peak area ratios for citrate:lactate and GPC:lactate were significantly different (P C 0.01) between the control group and the spermatogenic failure or obstructive axoospennia groups. A significant difference was also found in GPE:GPC peak intensity ratio between spermatogenic failure and obstructive azoospermia subjects (P < 0.001). These re-