The Kirby Institute. HIV, viral hepatitis and sexually transmissible infections in Australia. Annual Surveillance Report 2023. Sydney; The Kirby Institute, UNSW: 2023. 2014 National HIV Testing Policy. v1.0. Available at http://testingportal.ashm.org.au/resources/2014_National_HIV_Testing_Policy_v1.pdf (last accessed 10 August 2016). Hoyt MJ, Storm DS, Aaron E, Anderson J. Preconception and contraceptive care for women living with HIV. Infect Dis …
http://www.APRegistry.com Antiretroviral Pregnancy Register maintains an up-to-date registry of antiretroviral drug exposure during pregnancy. http://aidsinfo.nih.gov/guidelines 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. Family Planning NSW: Contraception: an Australian clinical practice handbook. 4th edition; 2016. MotherSafe http://www.mothersafe.org.au Counselling service for …
Case Study 1 Agnes is a 28-year-old woman from South Africa. She arrived in Australia 6 months ago and has no family supports. She is diagnosed as having HIV infection and she is also 10 weeks pregnant. She is non-Medicare eligible at this time. Initial investigations indicate a CD4+ T cell count of 190/μL and …
Consultations concerning HIV and pregnancy issues may involve serodiscordant couples or, less often, seroconcordant couples. For these couples, referral to an HIV Specialist for expert consultation is recommended. In brief, recent studies have provided evidence of the effectiveness of ART in preventing sexual transmission of HIV, i.e., treatment as prevention (HPTN 052 and Partner Study).[45, …
Reproductive options for HIV seroconcordant and serodiscordant couples Read More »
It is vital to involve a paediatric multidisciplinary team before the birth of the infant. The team, consisting of a paediatrician, nursing staff, social worker, and dietitian, will support the mother and family in many ways, including the following: Counselling and support of the mother and her partner during pregnancy and after delivery of the …
Patients with HIV who desire or have indications for diagnostic testing during pregnancy (e.g., abnormal ultrasound or aneuploidy screening) should be counselled about the potential risk of perinatal HIV transmission, along with other risks of the procedure, so that they can make informed decisions about invasive testing. Although the data on women who are receiving …
HIV viral load More frequent HIV viral load monitoring is recommended in pregnant women with HIV infection to ensure rapid and sustained virological suppression has been achieved. HIV viral load should be assessed at the initial visit, 2 – 4 weeks after initiating or changing ART, monthly until undetectable, and at least 3 monthly thereafter. …
Monitoring of HIV-infected women during pregnancy Read More »
Early and more recent data are conflicting in regard to whether ART during pregnancy is associated with adverse pregnancy outcomes, specifically with preterm delivery (before 37 weeks). Multiple observational studies have detected small but significant increases in preterm birth with PI-based and non PI-based ART. [40, 41] Conflicting findings may be influenced by a number …
The following section is included in detail to highlight the changing safety status of newly introduced antiretroviral drugs and how ART guidelines will reflect the currently available data as more women and infants are exposed in pregnancy. Dolutegravir Botswana embarked upon a birth outcome surveillance programme in 2014. In 2018, the Tsepamo Study in Botswana …
Several pregnancy-specific issues will need special consideration when using ART in pregnant women. These include the efficacy of antiretroviral drugs in prevention of mother-to-child HIV transmission, maternal and foetal toxicity, teratogenicity, PK profile, antiretroviral drug resistance testing before and during pregnancy, transplacental transfer of antiretroviral drugs, timing of treatment initiation, hyperemesis and nausea of pregnancy. …
Special issues when using antiretroviral therapy in pregnancy Read More »
Developing a sustainable HIV, Viral Hepatitis and Sexual Health Workforce
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