High HIV prevalence in gestational trophoblastic neoplasia patients: experience from an expert UK treatment centre.

Abstract

To assess the HIV prevalence in patients diagnosed with Gestational trophoblastic neoplasia. A retrospective, single centre cohort study, between 1st January 2015 and 31st December 2021. The Sheffield Trophoblastic Disease Centre, in Sheffield, U.K, a specialised, quaternary referral centre for the monitoring and treatment of Gestational trophoblastic disease (GTD)/neoplasia (GTN). 3,591 patients referred to the Sheffield Trophoblastic Disease Centre, with a diagnosis of GTD, of which 221 (6.2%) were treated for GTN. 'Opt out' HIV testing in patients treated for GTN. Prevalence of HIV positive tests in GTN patients. HIV testing was performed in 93% GTN patients (n = 205/221). Overall, 1.3% of GTN patients (n = 3/221) were HIV positive, involving two known-HIV positive patients and one new diagnosis. This equates to a HIV prevalence of 14:1,000 which is ∼7-9x higher than the HIV prevalence in Sheffield (1.9 per 1,000) and Yorkshire and Humber (1.5 per 1,000). Given the extremely high HIV prevalence in our population, 'opt out' HIV testing is recommended within our specialist trophoblastic centre for all referred GTD and GTN patients. There is little reason to suspect that the prevalence of HIV positive patients is any lower in the cohort of GTD patients referred to specialist trophoblastic centres for hCG screening alone, without requiring chemotherapy, particularly considering that most GTN arises from GTD.