Special Patient Populations

Current recommendations for specific antiretroviral drugs are available in existing guidelines (USA and UK). [9, 30] Preferred antiretroviral drugs are those with clinical trial data in adults that have demonstrated: Optimal efficacy and durability Acceptable toxicity and ease of use Pregnancy-specific pharmacokinetic (PK) data available to guide dosing No associated teratogenic effects No reported maternal, …

Recommendations for the use of antiretroviral drugs in pregnancy Read More »

Antiretroviral drugs for prevention of perinatal transmission of HIV are recommended for all pregnant women, regardless of CD4+ T cell counts and HIV viral load, and will reduce perinatal transmission through a number of mechanisms. Antenatal drug administration decreases maternal HIV viral load in blood and genital secretions. A number of studies have shown that …

Principles of antiretroviral use in pregnancy Read More »

The first major study of HIV prevention in pregnancy was the Paediatric AIDS Clinical Trials PACTG 076 in 1994. This placebo-controlled study demonstrated that the administration of zidovudine to pregnant women and their infants could reduce the risk of perinatal HIV transmission by 67.5% overall.[1]0, 11] More recent studies have explored the efficacy of shorter, …

Prevention of mother-to-child transmission Read More »

Previous studies have indicated that one in five women with HIV infection are not using any contraceptive method, a rate which is higher than in the general population. High rates of unintended pregnancies have been reported in some settings with proportions ranging from 50-85%, with condoms often being the most commonly used contraceptive method. [5] …

Contraception Read More »

Routine reproductive counselling is essential for all women with HIV infection. [3] In a survey of 700 women with HIV infection in 2011, 22% of whom became pregnant after an HIV diagnosis, 58% had never discussed pregnancy or treatment options before pregnancy and 42% had limited or no knowledge of antiretroviral therapy (ART) options. [4] …

Conception counselling Read More »

The National HIV Testing Policy recommends that all pregnant women should be routinely offered HIV testing. This should be performed with pre-test discussion, preferably at the first antenatal visit.[2] The risk of perinatal transmission of HIV can be significantly reduced by a number of established evidence-based antenatal and postnatal interventions and appropriate care throughout the …

HIV testing in pregnancy – a priority Read More »

Virginia Furner The Albion Centre, Sydney, NSW Women with human immunodeficiency virus (HIV) infection in Australia are now choosing pregnancy as a proactive, positive, reproductive option. In addition, some women will be initially diagnosed as having HIV infection during a pregnancy. All with HIV women should have access to all the recommended strategies to prevent …

Pregnancy and reproductive health in women with HIV infection Read More »