Multiple-marker screening in human immunodeficiency virus–positive pregnant women: screen positivity rates with the triple and quad screens

Abstract

Objective The study was undertaken to determine the screen-positive rates of multiple-marker screening tests in pregnant women who are positive for human immunodeficiency virus (HIV) at our institution for open neural tube defects and aneuploidy, for both triple (α-fetoprotein, human chorionic gonadotropin [hCG], unconjugated estriol) and quad (α-fetoprotein, hCG, unconjugated estriol, inhibin A) screens, and to compare these rates with a matched control group. Study design A 1:1 matched case-control study was performed comparing multiple marker screening test results in 34 HIV-positive women with age- and race-matched HIV-negative controls. Individual serum markers and screen positive rates for both the triple and quad screens were compared among the cases and controls. Results In each group, there were 19 women with triple screens and 15 with quad screens. Serum hCG multiples of the median were significantly higher in the HIV-positive compared with the HIV-negative women ( P = .033). There was no difference in screen positive rates between the cases and controls using the triple screen, but there was a significantly higher overall screen positive rate in the HIV-positive group when the quad screen was used (33% vs 7%, P = .046). Conclusion There is a significantly higher rate of overall quad screen positivity on multiple-marker screening among HIV-positive women compared with a matched control group.