Human papillomavirus prevalence in pregnancy

90

Citations from the Literature

bodies to HIV-l gene products. Results - With conventional western blotting we found IgA class antibodies to HIV-l proteins in serum from these out of 12 infected children; in two of these three the serum was collected at age 3 months (positive controls). Radioimmune western blotting detected both IgA and IgM antibodies in serum from all infected children tested, whereas all serum from uninfected children born to seropositive and seronegative mothers showed no such antibodies. Conclusion - Although the technique should be tested on more patients, radioimmune western blotting seems to be a valuable tool for serological diagnosis of congenital HIV-l infection at birth in neonates born to seropositive mothers. HlVrepBc8tion~thcfiratweetisofIife Krivine A, Firtion G; Cao L, Francoual C; Henrion R; Lebon P Department of Virology, Hopital Saint- Vincent-de-Paul, University Paris V. 82 Avenw Denfert-Rochereau.

75014 Paris, FRA

LANCET 1992 339/8803 (1187- 1189) Diagnosis of HIV infection among children born to HIVpositive mothers can be made in the first 12 months, but few studies have examined HIV status during the first weeks of life. In a prospective longitudinal study of 50 infants born to HIV-l seropositive women, blood samples were obtained at birth and at 4-9 weeks and 5-9 months of age and were tested for HIV-l by the polymerase chain reaction (PCR), viral culture and p24 antigen measuremen ts. 16 were diagnosed as HIV-infected by the age of 4-9 weeks according to both PCR and culture; by contrast, infection could be detected in only 5 children at birth. No changes in HIV status were observed between 4-9 weeks and 5-9 months in the 44 children who could be retested. Perinatal HIV-I infection can therefore be diagnosed in the first 2 months of life, either by PCR or viral culture. Our inability to detect HIV-1 infection at birth in almost 79% of babies subsequently found infected suggests an active replication of HIV during the first weeks of life. Our results might favour the hypothesis that transmission of HIV-1 takes place either at the end of pregnancy or at delivery.

volunteer blood donors. The risk of transmission to the neonate depends on the trimester at exposure. No perinatal transmission has been shown after acute maternal infection in the second trimester. Based on the few reported cases, chronic maternal infection or acute infection in the third trimester may result in neonatal infection rates of 45-87.5%. Universal screening is probably not cost-effective because the prevalence is low and over 79% of screening tests can be falsely positive using the currently approved assay. Selective screening of high risk patients is recommended. HumanpapBIomaM prevaleoce In pregoancy Kemp EA, Hakenewerth AM; Laurent SL; Gravitt Stoerker J

PE;

Dept. of Obstetrics and Gynecology, Carolinas Medical Center, P.O. Box 32861, Charlotte, NC 28232, USA

OBSTET GYNECOL 1992 79/5 I (649-656) Conventional wisdom has long held that human papillomavirus (HPV) prevalence is increased in pregnancy. We examined cervical swabs of 375 women for HPV DNA using polymerase chain reaction (PCR) and ViraPap with an expanded probe range. Of this population, 115 were pregnant (42 in the ftrst trimester, 46 in the second and 27 in the third) and 100 were postpartum. The control population consisted of 160 women who were otherwise similar to the pregnant population but were not pregnant or postpartum. Crude associations were examined between HPV prevalence at defined high, low and overall levels and the pregnancy status. Multivariate analysis indicated no statistically significant association between :the prevalence at any level of infection and pregnancy status. As expected, associations were found between measures of HPV prevalence and both Papanicolaou smear results and warts seen on examination. No association was found for race, smoking behavior, or number of sexual partners and HPV prevalence. The estimated risk of an HPV infection decreased as the age of the women increased. We conclude that a signhicant relationship between pregnancy and HPV prevalence has yet to be established.

Hapatitis c in oIsde.eia and gynecoIogy Lynch-Salamon DI; Combs CA

ONCOLOGY

Div. of Maternal-Fetal Medicine, Department of Obstetrics/ Gynecology, Univ. of Cincinnati COB. Medicine, Cincinnati, OH 45267-0526, USA

Mild cervical dyskaryoak Safety of cytological aurveiIlance Jones MH; Jenkins D; Cuxick J; Wolfendale MR; Jones JJ; Balogun-Lynch C, Usherwood MMcD, Singer A c/o Dr J.J. Jones, Leicestershire Dirt. Hlth Authority, 20-28

OBSTET GYNECOL 1992 79/4 (621-629) Because of the risk of perinatal transmission and possible sexual transmission, it is important for obstetrician-gynecologists to keep abreast of the rapidly expanding literature on hepatitis C. Acute hepatitis C represents about 5% of all reported cases of hepatitis. Approximately 50% of acute infections progress to chronic liver disease. Risk factors for infection include intravenous (IV) drug use (2 l-42% of cases), previous blood transfusion (6-17%) and multiple sexual partners (6%); 40-50% of cases have no identified risk factors. The seroprevalence of anti-hepatitis C antibody is 70.8% in IV drug users, 11.6% in patients with human immunodeficiency virus, 8.8% in prostitutes, 1.2% in hospital personnel and 0.5- 1.4% in Int J Gynecol Obstet 40

Princess Road West, Leicester LEl 6TY, GBR

LANCET 1992 33918807(1440-1443) How best to manage women who are found on cervical screening to have mild dyskaryosis remains controversial. Cytological surveillance misses some lesions picked up by colposcopy, but colposcopy is emotionally traumatic for women, the majority of whom will have a normal result. To determine what proportion of lesions are missed by cytological surveillance and whether any abnormalities persist after colposcopy, we studied, by means of colposcopy and biopsy, the prevalence of cervical intraepithelhd neoplasia (GIN) and subclinical human papillomavirus infection (HPVI) in two