HIV in pregnant women and prevention of perinatal transmission
Michelle Giles
+ Author Affiliations
- Author Affiliations
Department of Infectious Diseases
Monash University and The Alfred Hospital
Level 2, Burnet Institute
85 Commercial Road
Prahran, Vic. 3004, Australia
Fax: +61 3 9076 2431
Email: m.giles@alfred.org.au
Microbiology Australia 36(4) 182-184 https://doi.org/10.1071/MA15064
Published: 19 October 2015
Abstract
Women with HIV who have access to treatment can expect to have a normal life expectancy. With effective antiretroviral therapy, an undetectable viral load, and avoidance of breastfeeding, the rate of perinatal transmission is extremely low (<1%). A Caesarean section is no longer routinely recommended nor is intrapartum zidovudine. Women living with HIV should be supported in their decision regarding parenthood given their excellent prognosis, low risk of perinatal transmission and reproductive rights. If interventions to reduce perinatal HIV transmission during pregnancy and post-partum are embraced, women can expect to have an uninfected infant.
References
[1] Samji, H. et al. (2013) Closing the gap: increases in life expectancy among treated HIV-positive individuals in the United States and Canada. PLoS One 8, e81355.| Closing the gap: increases in life expectancy among treated HIV-positive individuals in the United States and Canada.Crossref | GoogleScholarGoogle Scholar | 24367482PubMed |
[2] Mandelbrot, L. et al. (2015) No perinatal transmission of HIV-1 from women with effective antiretroviral therapy starting before conception. Clin. Infect. Dis. , civ578.
| No perinatal transmission of HIV-1 from women with effective antiretroviral therapy starting before conception.Crossref | GoogleScholarGoogle Scholar | 26197844PubMed |
[3] Cohen, M.S. et al. (2011) Prevention of HIV-1 infection with early antiretroviral therapy. N. Engl. J. Med. 365, 493–505.
| Prevention of HIV-1 infection with early antiretroviral therapy.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3MXhtVars7jF&md5=6140aaa04d514bf049cf3a65e46d8270CAS | 21767103PubMed |
[4] Baeten, J.M. et al. (2012) Antiretroviral prophylaxis for HIV-1 prevention among heterosexual men and women. N. Engl. J. Med. 367, 399–410.
| Antiretroviral prophylaxis for HIV-1 prevention among heterosexual men and women.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC38XhtlSltrbK&md5=1b1ba52eeedbfc675f8e62e0bee64e36CAS | 22784037PubMed |
[5] Thigpen, M.C. et al. (2012) Antiretroviral preexposure prophylaxis for heterosexual HIV transmission in Botswana N. Engl. J. Med. 367, 423–434.
| Antiretroviral preexposure prophylaxis for heterosexual HIV transmission in BotswanaCrossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC38XhtlSltrbE&md5=63b29a69462ae3d70df595d4c378d6beCAS | 22784038PubMed |
[6] Vernazza, P.L. et al. (2011) Pre-exposure prophylaxis and timed intercourse for HIV-serodiscordant couples willing to conceive a child AIDS 25, 2005–2008.
| Pre-exposure prophylaxis and timed intercourse for HIV-serodiscordant couples willing to conceive a childCrossref | GoogleScholarGoogle Scholar | 21716070PubMed |
[7] Siegfried, N. et al. (2011) Antiretrovirals for reducing the risk of mother-to-child transmission of HIV infection. Cochrane Database Syst. Rev. , CD003510.
| Antiretrovirals for reducing the risk of mother-to-child transmission of HIV infection.Crossref | GoogleScholarGoogle Scholar | 21735394PubMed |
[8] Cooper, E.R. et al. (2002) Combination antiretroviral strategies for the treatment of pregnant HIV-1-infected women and prevention of perinatal HIV-1 transmission. J. Acquir. Immune Defic. Syndr. 29, 484–494.
| Combination antiretroviral strategies for the treatment of pregnant HIV-1-infected women and prevention of perinatal HIV-1 transmission.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BD38XjvFSrt7s%3D&md5=0d3c6227e49cc9b93333e5608b986df7CAS | 11981365PubMed |
[9] Antiretroviral Pregnancy Registry Steering Committee (2015) Antiretroviral Pregnancy Registry International Interim Report for 1 January 1989 through 31 January 2015. Willington, NC: Registry Coordinating Centre. www.APRegistry.com
[10] Briand, N. et al. (2013) Cesarean section for HIV-infected women in the combination antiretroviral therapies era, 2000–2010. Am. J. Obstet. Gynecol. 209, 335.e1–335.e12.
| Cesarean section for HIV-infected women in the combination antiretroviral therapies era, 2000–2010.Crossref | GoogleScholarGoogle Scholar |
[11] Read, J.S. and Newell, M.K. (2005) Efficacy and safety of cesarean delivery for prevention of mother-to-child transmission of HIV-1 Cochrane Database Syst. Rev. , CD005479.
| 1:STN:280:DC%2BD28%2FhtFaktg%3D%3D&md5=1748ab55369125f72d33a41a409d974eCAS | 16235405PubMed |
[12] British HIV Association (2014) British HIV Association guidelines for the management of HIV infection in pregnant women 2012 (2014 interim review). HIV Med. 15, 1–77.
| 25604045PubMed |
[13] Panel on Treatment of HIV-Infected Pregnant Women and Prevention of Perinatal Transmission (2015) Recommendations for use of antiretroviral drugs in pregnant HIV-1-infected women for maternal health and interventions to reduce perinatal HIV transmission in the United States. http://aidsinfo.nih.gov/contentfiles/lvguidelines/PerinatalGL.pdf
[14] White, A.B. et al. (2014) Antiretroviral interventions for preventing breast milk transmission of HIV. Cochrane Database Syst. Rev. , CD011323.
| Antiretroviral interventions for preventing breast milk transmission of HIV.Crossref | GoogleScholarGoogle Scholar | 25280769PubMed |
[15] Jamieson, D.J. et al. (2012) Maternal and infant antiretroviral regimens to prevent postnatal HIV-1 transmission: 48-week follow-up of the BAN randomised controlled trial. Lancet 379, 2449–2458.
| Maternal and infant antiretroviral regimens to prevent postnatal HIV-1 transmission: 48-week follow-up of the BAN randomised controlled trial.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC38Xmt1Gkurw%3D&md5=846ca8400482a71799c24182274d33daCAS | 22541418PubMed |
[16] The Kesho Bora Study Group de Vincenzi, I. (2011) Triple antiretroviral compared with zidovudine and single-dose nevirapine prophylaxis during pregnancy and breastfeeding for prevention of mother-to-child transmission of HIV-1 (Kesho Bora study): a randomised controlled trial. Lancet Infect. Dis. 11, 171–180.
| Triple antiretroviral compared with zidovudine and single-dose nevirapine prophylaxis during pregnancy and breastfeeding for prevention of mother-to-child transmission of HIV-1 (Kesho Bora study): a randomised controlled trial.Crossref | GoogleScholarGoogle Scholar | 21237718PubMed |
[17] British HIV Association (BHIVA) and Children’s HIV Association (CHIVA) (2010) Position Statement on Infant Feeding in the UK. November.
