English Version
An estimated 16.4 million women worldwide are living with human immunodeficiency virus (HIV) infection; 600,000 children are infected annually, most of them by mother-to-child transmission. Interventions designed to reduce pernatal transmission of HIV in the developing world have been described elsewhere. This article focuses on the managementof HIV infection in pregnant women in developed countries where antiretroviral therapy, scheduled cesarean delivery, and alternatives to breast feeding are available (Table 1). Standards of care for HIV change rapidly, and up to date recommendations are available on the Web (e.g.,at http://www.hivatis.org). Clinicians who care for HIV-infected women of reproductive age should provide family planning services and counseling to optimize the use of medications and health status, including updating immunizations, before a pregnancy occurs.
INTERACTION BETWEEN HIV INFECTION AND PREGNANCY
Studies in the United States and Europe have shown no effect of pregnancy on the progression of HIV disease. The largest study included women with a known date of seroconversion and reported that the adjusted relative risk of progression from HIV infection to the acquired immunodeficiency syndrome (AIDS) associated with pregnancy was 0.7 (95 percent confidence interval, 0.4 to 1.2). Reports from developing countries suggest that progression accelerates with pregnancy, butit is difficult to interpret such reports because the samples are small and the studies are subject to selection bias related to the presence of indications for testing.
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Studies in the United States and Europe have shown no effect of pregnancy on the progression of HIV disease. The largest study included women with a known date of seroconversion and reported that the adjusted relative risk of progression from HIV infection to the acquired immunodeficiency syndrome (AIDS) associated with pregnancy was 0.7 (95 percent confidence interval, 0.4 to 1.2). Reports from developing countries suggest that progression accelerates with pregnancy, butit is difficult to interpret such reports because the samples are small and the studies are subject to selection bias related to the presence of indications for testing.
Journals for full download on the link below
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