Human immunodeficiency virus in pregnancy

Mercey, Danielle; de Ruiter, Annemiek

doi:10.1016/j.ogrm.2008.11.008

« Previous Next »Obstetrics, Gynaecology and Reproductive Medicine
Volume 19, Issue 3 , Pages 75-79, March 2009

Human immunodeficiency virus in pregnancy

Danielle Mercey MB ChB FRCP is a Senior Lecturer at the Centre for Sexual Health and HIV, University College London, London, UK

Annemiek de Ruiter MBBS FRCP is a Consultant at the Department of Genitourinary Medicine and HIV, Guy's & St Thomas' NHS Foundation Trust, London, UK

Abstract

Most human immunodeficiency virus (HIV) infection in women of childbearing age occurs in resource poor countries. However, increasing numbers of infected women are known to reside in the UK. In developed countries, with appropriate healthcare, HIV infection in adults may be regarded as a chronic manageable condition and mother-to-child transmission (MTCT) can be almost totally prevented.

Despite great improvements in antenatal testing in the UK, the greatest single contributor to MTCT is failure to diagnose HIV in pregnancy. Once diagnosed, HIV in pregnancy is best managed by a specialist multidisciplinary team, who can maximise the mother’s health and reduce the risk of MTCT to less than 1%.

The British HIV Association has recently published its 2008 guidelines for the management of HIV in pregnancy. Avoidance of breastfeeding and appropriate use of antiretrovirals with or without pre-labour Caesarean section remain the main interventions minimising the risk of MTCT.

Keywords: antiretrovirals, breastfeeding, epidemiology, HIV, pregnancy, pre-labour Caesarean section