Natural Pregnancies in HIV-Serodiscordant Couples Receiving Successful Antiretroviral Therapy

Summary: Increasing numbers of HIV-serodiscordant heterosexual couples are concerned about the chances for pregnancy. We reviewed all natural pregnancies attained by HIV-serodiscordant couples seen in 3 clinics in Spain, in which the infected partner had undetectable plasma viremia while receiving highly active antiretroviral therapy (HAART). In the case of HIV-infected mothers, only those with undetectable viremia during pregnancy and at delivery were chosen. A total of 62 HIV-serodiscordant couples, 22 HIV-infected women (mean CD4 count of 522 cells/[mu]L, 55% hepatitis C virus [HCV]-seropositive) and 40 HIV-infected men (mean CD4 count of 629 cells/[mu]L, 75% HCV-seropositive), were recorded. Overall, 76 natural pregnancies occurred, and 68 children were born. There were 9 fetal deaths, 1 twin pregnancy, 6 couples with 2 consecutive babies, and 4 couples with 3 consecutive newborns. There were no cases of HIV seroconversion in uninfected sexual partners. One case of vertical HIV transmission occurred, however. Serodiscordant couples attaining natural pregnancy are exposed to a negligible risk of sexual transmission of HIV when the infected partner presents with complete suppression of plasma viremia while receiving HAART.

JAIDS Journal of Acquired Immune Deficiency Syndromes. 43(3):324-326, November 1, 2006.

Barreiro, Pablo MD, PhD *; del Romero, Jorge MD +; Leal, Manuel MD, PhD ++; Hernando, Victoria MD +; Asencio, Roman MD ++; de Mendoza, Carmen PhD *; Labarga, Pablo MD, PhD *; Nunez, Marina MD, PhD *; Ramos, Jose Tomas MD, PhD [S]; Gonzalez-Lahoz, Juan MD, PhD *; Soriano, Vincent MD, PhD *; on behalf of the Spanish HIV-Discordant Study Group