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HIV in pregnancy
1Department of Medicine, St. Luke's-Roosevelt Hospital Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA.
Pregnancy in individuals infected with HIV has become an important problem because of a fourfold rise of infection in women of childbearing age in the developed world. The incidence of vertical transmission varies in different continents and is highest in Africa. Transmission may occur in utero (antepartum), during delivery (intrapartum), or after birth (postpartum), occurring during the latter period, in many cases, through breastfeeding. Maternal viral burden around the time of delivery is the strongest determinant of the risk of disease transmission. While breastfeeding may account for up to one-third of cases of vertical transmission in Africa, the benefits of breastfeeding outweigh its risks, even in HIV infection, and breastfeeding is recommended in those areas. Treatment of the mother with antiretroviral agents significantly decreases the risk of vertical transmission.
Pregnancy in individuals infected with HIV has become an important problem because of a fourfold rise of infection in women of childbearing age in the developed world. The incidence of vertical transmission varies in different continents and is highest in Africa. Transmission may occur in utero (antepartum), during delivery (intrapartum), or after birth (postpartum), occurring during the latter period, in many cases, through breastfeeding. Maternal viral burden around the time of delivery is the strongest determinant of the risk of disease transmission. While breastfeeding may account for up to one-third of cases of vertical transmission in Africa, the benefits of breastfeeding outweigh its risks, even in HIV infection, and breastfeeding is recommended in those areas. Treatment of the mother with antiretroviral agents significantly decreases the risk of vertical transmission.