Pregnancy and Optimal Care of HIV-Infected Patients
- Kenneth H. Mayer, Section Editor
- 1Department of Obstetrics and Gynecology, Women & Infants Hospital, Providence, Rhode Island
- 2Departments of Obstetrics and Gynecology, Providence, Rhode Island
- 3Medicine, Miriam Hospital, Alpert Medical School at Brown University, Providence, Rhode Island
- Reprints or correspondence: Dr. Brenna L. Anderson, 101 Dudley St., 3rd Fl. Maternal Fetal Medicine, Providence, RI 02905 (banderson{at}wihri.org).
Abstract
Human immunodeficiency virus (HIV) infection during pregnancy is a condition that requires multidisciplinary care. Care must be rendered that is appropriate for both the mother and the fetus. Prevention of mother-to-child transmission of HIV is of paramount concern. To prevent transmission, universal testing for HIV infection in pregnant women is ideal. In the United States and other developed countries, great strides have been made toward decreasing the risk of HIV transmission to infants to <2% with use of a combination of highly active antiretroviral therapy during the antepartum period and during labor and delivery, scheduled cesarean section when appropriate, avoidance of breast-feeding, and 6 weeks of zidovudine prophylaxis for infants. The continuation of antiretroviral therapy after delivery depends on the needs of the mother with regard to treatment of her own health. In resource-limited countries, where simplified and shortened courses of antiretroviral regimens have been used, reduction in mother-to-child transmission has also been shown, although not as effectively as that with highly active antiretroviral therapy. In these settings, exclusive breast-feeding for 6 months is recommended to reduce the risk of postnatal transmission.
- Received July 1, 2008.
- Accepted October 17, 2008.
- © 2009 by the Infectious Diseases Society of America
