Human immunodeficiency virus infection in pregnancy

Area of Science:

• Obstetrics and Gynecology
• Infectious Diseases
• Virology

Background:

• The human immunodeficiency virus (HIV) epidemic has seen significant transformation.
• Antiretroviral therapies offer improved prognosis for infected women and high likelihood of uninfected births.
• Highly active antiretroviral therapy (HAART) presents complex regimens with potential toxicities and risks.

Purpose of the Study:

• To outline obstetricians' dual responsibilities in managing HIV-infected pregnant women.
• To detail strategies for optimizing maternal care and minimizing mother-to-child HIV transmission.
• To emphasize the importance of early HIV status determination in pregnancy.

Main Methods:

• Monitoring immunological and virological status, including resistance testing.
• Guiding therapy initiation and regimen selection based on test results.
• Considering pregnancy-specific risks of HAART agents.

Main Results:

• Achieving undetectable viral load minimizes transmission risk, reduces C-section need, and optimizes prognosis.
• Early HIV testing enables timely intervention and maximizes therapeutic benefits.
• Delayed therapy initiation is possible in non-pregnant women if CD4 count and viral load are stable.

Conclusions:

• Optimal care for HIV-infected pregnant women involves balancing maternal health with preventing transmission.
• HAART is effective but requires careful monitoring for side effects and adherence.
• Universal early HIV screening in pregnancy is essential for realizing the full benefits of modern antiretroviral therapy.