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| {{AIDS}}
| | #REDIRECT [[HIV and pregnancy#Treatment]] |
| {{CMG}} '''Associate Editors-in-Chief:''' [[User:Ujjwal Rastogi|Ujjwal Rastogi, MBBS]] [mailto:urastogi@perfuse.org]
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| ==Overview==
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| The risk of HIV transmission from mother to infant had declined to low levels with the use of ART in USA and Europe. The risk for [[perinatal]] HIV transmission can be reduced to <2% through the use of antiretroviral regimens and [[obstetrical]] interventions (i.e., [[zidovudine]] or [[nevirapine]] and elective [[cesarean]] section at 38 weeks of pregnancy) and by avoiding [[breastfeeding]].<ref name="pmid16088819">{{cite journal |author=Bulterys M, Weidle PJ, Abrams EJ, Fowler MG |title=Combination antiretroviral therapy in african nursing mothers and drug exposure in their infants: new pharmacokinetic and virologic findings |journal=J. Infect. Dis. |volume=192 |issue=5 |pages=709–12 |year=2005 |month=September |pmid=16088819 |doi=10.1086/432490 |url=http://www.jid.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=16088819 |accessdate=2012-02-22}}</ref>
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| == Therapeutic Goals==
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| *Reduction of perinatal transmission of infection.
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| *Treatment of maternal HIV disease.
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| ==ART Regimen==
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| Potential benefits and risks of therapy should be discussed with the patients by the health care provider. Following facactors are taken into consideration for ART Selection:
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| * Comorbidities.
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| * Patient adherence and convenience of therapy.
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| * Potential for adverse drug effects on the mother and drug interactions.
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| * Pharmacokinetic changes in pregnancy
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| * Results of genotypic resistance testing.
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| *Potential teratogenic effects on the fetus and other adverse effects on the fetus or newborn.
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| ===ART for maternal health===
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| Treatment of HIV infection is no different for the pregnant female than the nonpregnant patient. For effective viral suppression and immune recovery, three-drug combination therapy is needed
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| ==Counselling==
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| Pregnant women who are HIV-infected should be counseled concerning their options (either on-site or by referral), given appropriate antenatal treatment, and advised not to breastfeed their infants.
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| ==WHO Recommendations==
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| [http://aidsinfo.nih.gov/contentfiles/Peri_Recommendations.pdf]
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| *All pregnant women who require therapy for their own health should receive a combination antepartum antiretroviral (ART) drug regimen containing at least three drugs for treatment, which will also reduce the risk of perinatal transmission.
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| * Combination antepartum drug regimens are also recommended for prevention of perinatal transmission in women who do not yet require therapy for their own health.
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| * ART prophylaxis is more effective when given for a longer than a shorter duration. Therefore, ART drugs should be started as soon as possible in women who require treatment for their own health (AI), and without delay after the first trimester in women who do not require immediate initiation of therapy for their own health, although earlier initiation can be considered in these women as well.
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| *In the absence of antepartum administration of ART drugs, ART drugs should be administered intrapartum in combination with infant ART prophylaxis to reduce the risk of perinatal transmission (AI); if antepartum and intrapartum ART drugs are not received, infant ART prophylaxis should be provided (see Infant Antiretroviral Prophylaxis) (AI).
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| *Adding single-dose intrapartum/newborn nevirapine to the standard antepartum combination ART regimens used for prophylaxis or treatment in pregnant women in the United States is not recommended. This is because the drug does not appear to provide additional efficacy in reducing transmission and it may be associated with development of nevirapine resistance (AI).
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| *Breastfeeding is not recommended for HIV-infected women in the United States—including those receiving combination antiretroviral therapy (ART)—because safe, affordable, and feasible alternatives are available (AII).
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| ==Reference==
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| {{reflist|2}}
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| {{Viral diseases}}
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| {{STD/STI}}
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| [[Category:HIV/AIDS]]
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| [[Category:Immune system disorders]]
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| [[Category:Infectious disease]]
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| [[category:viral diseases]]
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| [[Category:Sexually transmitted infections]]
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| [[Category:Syndromes]]
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| [[Category:Virology]]
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| [[Category:AIDS origin hypotheses]]
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| [[Category:Immunodeficiency]]
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| [[Category:Microbiology]]
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| {{Link FA|he}}
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| {{Link FA|vi}}
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| [[af:Vigs]]
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| [[als:AIDS]]
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| [[am:ኤድስ]]
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| [[an:SIDA]]
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| [[ar:متلازمة العوز المناعي المكتسب]]
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| [[ast:SIDA]]
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| [[az:QİÇS]]
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| [[bat-smg:AIDS]]
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| [[be-x-old:СНІД]]
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| [[bg:Синдром на придобитата имунна недостатъчност]]
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| [[bm:Sida]]
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| [[bn:এইডস]]
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| [[bs:Sida]]
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| [[ca:SIDA]]
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| [[cs:AIDS]]
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| [[da:Aids]]
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| [[de:Aids]]
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| [[dv:އެއިޑްސް ބަލި]]
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| [[el:AIDS]]
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| [[eo:Aidoso]]
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| [[es:SIDA]]
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| [[et:AIDS]]
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| [[eu:Hartutako Immuno Eskasiaren Sindromea]]
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| [[fa:ایدز]]
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| [[fi:AIDS]]
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| [[fr:Syndrome d'immunodéficience acquise]]
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| [[fur:AIDS]]
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| [[ga:SEIF]]
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| [[gd:AIDS]]
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| [[gl:SIDA]]
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| [[gu:એડ્સ]]
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| [[he:איידס]]
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| [[hi:एड्स]]
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| [[hr:Sindrom stečene imunodeficijencije]]
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| [[ht:Sida]]
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| [[hu:AIDS]]
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| [[hy:ՁԻԱՀ]]
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| [[id:AIDS]]
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| [[is:Alnæmi]]
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| [[it:AIDS]]
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| [[ja:後天性免疫不全症候群]]
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| [[ka:შიდსი]]
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| [[ki:AIDS]]
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| [[km:ជំងឺអេដស៍]]
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| [[kn:ಏಡ್ಸ್ ರೋಗ]]
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| [[ko:에이즈]]
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| [[ku:AIDS]]
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| [[la:SCDI]]
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| [[lb:Aids]]
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| [[ln:Sida]]
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| [[lo:ເອດສ໌]]
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| [[lt:AIDS]]
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| [[lv:AIDS]]
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| [[mk:СИДА]]
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| [[ml:എയ്ഡ്സ്]]
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| [[mn:Дархлалын олдмол хомсдол]]
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| [[mr:एड्स]]
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| [[ms:AIDS]]
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| [[mt:AIDS]]
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| [[new:एड्स]]
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| [[nl:Aids]]
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| [[nn:Hiv/aids]]
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| [[no:Aids]]
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| [[oc:SIDA]]
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| [[pl:Zespół nabytego niedoboru odporności]]
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| [[ps:اېډز]]
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| [[pt:Síndrome da imunodeficiência adquirida]]
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| [[qu:Unquy hark'aypa chaskisqa waqlliynin]]
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| [[ro:SIDA]]
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| [[ru:Синдром приобретённого иммунного дефицита]]
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| [[scn:AIDS]]
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| [[sh:AIDS]]
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| [[si:ඒඩ්ස්]]
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| [[simple:AIDS]]
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| [[sk:Aids]]
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| [[sl:Aids]]
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| [[sr:Сида]]
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| [[sv:Aids]]
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| [[sw:Ukimwi]]
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| [[ta:எய்ட்ஸ்]]
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| [[te:ఎయిడ్స్]]
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| [[tg:СПИД]]
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| [[th:เอดส์]]
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| [[tr:AIDS]]
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| [[tt:AİDS]]
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| [[uk:СНІД]]
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| [[ur:محصولی کسرمناعی متلازمہ]]
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| [[uz:Orttirilgan Imunitet Tanqisligi Sindromi]]
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| [[vec:AIDS]]
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| [[vi:AIDS]]
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| [[yi:עידס]]
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| [[yo:AIDS]]
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| [[zh:艾滋病]]
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| [[zh-min-nan:AIDS]]
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