Twin pregnancies involve greater risk of mother-to-child HIV transmission unless potent anti-HIV drugs used

Source: Aidsmap

Michael Carter, Wednesday, May 09, 2007

Twin pregnancies involve an increased risk of mother-to-child transmission of HIV, according to the results of a large French study published in the May 11th edition of AIDS. However, the risk was only higher in the period before effective anti-HIV treatment became available, and since 1997, the risk of mother-to-child HIV transmission has been equally low for both twin and single pregnancies. Known complications of twin pregnancies, especially premature rupture of the membranes, were associated with HIV transmission to a twin, and the investigators found that the twin born first was significantly more likely to acquire HIV infection than the second twin, probably because of exposure to HIV in the birth canal.

There has been little previous examination of the risks of mother-to-child transmission in twin pregnancies. The only study to examine this issue was conducted in the 1980s, before antiretroviral therapy was used to prevent mother-to-child transmission, and involved only 22 pairs of twins. It found that twin pregnancies did not involve any increased HIV transmission risk.

Nevertheless, it is well known that multiple pregnancies have an increased risk of complications, such as premature labour or rupture of the membranes, and such complications are known to increase the risk of mother-to-child transmission of HIV. (...)

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