Human papillomavirus (HPV) DNA loads of six oncogenic HPV types were measured by real-time PCR in cervical scrapes of human immunodeficiency virus (HIV)-infected and uninfected women. In both groups, HPV loads increased with the grade of cervical disease. HIV infection did not affect HPV loads in low-grade lesions but was associated with significantly higher HPV loads in severe dysplasia; highest loads were found in advanced HIV disease. Our data reflect the aggressive course of HPV infection in HIV-positive women.

Among the family of herpes viruses, only cytomegalovirus (CMV) and, to a lesser extent, human herpes virus 8 (HHV-8) are of relevance in transfusion medicine. Due to neutropism, herpes simplex viruses (HSV) types 1 and 2 are considered to be of minor relevance. However, several reports gave evidence that a HSV DNAemia might occur and HSV could therefore be transmissible by blood products. The aim of our study was to collect data about prevalence of HSV antibodies among blood donors and to clarify whether HSV DNAemia is possible. HSV antibody states of 653 blood donors were investigated. Blood specimens of 46 patients with primary and recurrent HSV infection were tested for HSV-1 and HSV-2 DNA using TaqMan polymerase chain reaction. In 505 of the 653 blood donors HSV antibodies were detectable, most of which were HSV-1 antibodies. HSV DNA was detected in plasma, but not in peripheral blood mononuclear cells (PBMCs) of seven rather seriously ill patients with primary herpes genitalis. No HSV viraemia was detectable in otherwise healthy patients with recurrent herpes labialis. Thus, HSV DNAemia is possible, but seems to be limited to primary infections and could not be detected in the recurrent infection. Therefore, blood donors with primary herpes infection should be deferred from donation. Blood donors with recurrent HSV infection are probably not at risk of transmitting HSV, but further studies are necessary to prove this hypothesis. Detection of HSV DNA in PBMCs as described formerly could not be confirmed by this study.

Fragestellung: Ziel der Untersuchung war, durch die Analyse der Schwangerschaftsverläufe HIV-infizierter Frauen und deren kindlichem Outcome an 10 deutschen gynäkologisch-geburtshilflichen HIV-Schwerpunktzentren die aufgetretenen Komplikationen und die resultierende Rate der vertikalen Transmission zu eruieren. Patientinnen und Methodik: Es wurden insgesamt 599 Schwangerschaften HIV-infizierter Mütter aus den Jahren 1999 -2003 aus 10 Einrichtungen der Schwerpunktversorgung in die Untersuchung aufgenommen. Folgende Parameter wurden hierbei erfasst: Infektionsmodus und -zeitpunkt der Mutter, Entbindungsmodus und Gestationsalter bei Geburt, CD4-Zellzahl bei Feststellung der Schwangerschaft sowie peripartal, Viruslast im Verlauf, ART (antiretrovirale Therapie) zuvor, ART in der Schwangerschaft, Schwangerschaftskomplikationen sowie kindlicher Infektionsstatus und allgemeiner kindlicher Gesundheitszustand. Ergebnisse: In 55 % der Fälle wurden eine oder mehrere Schwangerschaftskomplikationen dokumentiert, am häufigsten vorzeitige Wehentätigkeit (21,4%) und vorzeitiger Blasensprung (4,7 %). 595/599 Schwangerschaften endeten mit einer Lebendgeburt; davon wurden 98,3 % per Sectio caesarea entbunden. 20,3% der Schwangeren erlitten eine Frühgeburt. Fast 50 % der Frauen benötigten eine hochaktive antiretrovirale Mehrfachtherapie (HAART). Die kindliche Infektionsrate betrug 1,68 % (10 Kinder). Schlussfolgerung: Die Ergebnisse zeigen, dass eine in Abstract Objective: The study was performed to evaluate the course of pregnancies of HIV-infected women and their fetal outcome at 10 German reference gynecology/obstetrics departments to provide an overview of occurring complications and the rate of mother-to-child transmission (MTCT). Material and Methods: 599 pregnancies of HIV-infected mothers in the years 1999 -2003 at 10 German reference gynecology/obstetrics departments were recruited for evaluation. Data collected were: mode and time of infection and time of first diagnosis, mode and week of delivery, CD4 count and viral load at diagnosis of pregnancy and at delivery, antiretroviral therapy before and during pregnancy, pregnancy complications, fetal infection and general health status. Results: 595/599 pregnancies resulted in a live birth delivered in 98.3 % by cesarean section. In 55 % of the pregnancies one or more complications were documented. The most common were premature contractions (21.4 %) and premature rupture of the membranes (4.7 %). 20.3 % of the pregnant women delivered prematurely. Almost 50% of the women needed a highly active antiretroviral combination therapy (HAART). The vertical transmission rate was found to be 1.68 % (10 children). Conclusions:The study shows that the rate of mother-to-child transmission (MTCT) finally resulting after therapy according to the German-Austrian recommendations for HIV therapy in pregnancy is very low (under 2 %). Nevertheless, in order to achieve Originalarbeit 1058

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