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A summary of the current management of the HIV infected pregnant woman will be presented. This will include initial workup, if initially diagnosed in pregnancy, as most women are, or evaluation of those entering pregnancy already diagnosed with or without ARV therapy. Drug therapy will be discussed in terms of importance of viral load reduction to mother's health and reduction of perinatal transmission keeping in mind fetal/neonatal safety in relation to combination ARV agents. The controversy surrounding the role of cesarean section in management of the delivery to prevent perinatal transmission will be discussed in relation to the data available, from which recommendations have been suggested and current management of HIV infection per se as it relates to this data. Since many women do not get prenatal care and may not be adequately treated in pregnancy, or are not diagnosed until after delivery, the potential role of rapid HIV testing of laboring women and institution of ARV to reduce perinatal transmission in this "last frontier" group will be addressed, as it is in its infancy in the U.S. Finally, adherence issues will be discussed with the aim to increase an understanding of where many women are in their daily existence. |
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© 7th
Conference on Retroviruses and Opportunistic Infections, |