HIV and Pregnancy

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Original Editor - Simisola Ajeyalemi

Top Contributors - Simisola Ajeyalemi and Kim Jackson  

Introduction[edit | edit source]

Human immunodeficiency virus (HIV) transmission from mother to child can happen in utero, during labor, or after birth through breastfeeding. The World Health Organization estimates that without intervention, the rate of HIV transmission from an HIV-positive mother to her child during pregnancy, labour, delivery, or breastfeeding ranges from 15% to 45%.[1] However, the risk of mother-to-child transmission has been significantly reduced as a result of early detection, effective antiretroviral therapy (ART), appropriate delivery management, and breastfeeding avoidance. Women with HIV who begin ART prior to conception and maintain viral suppression to undetectable levels throughout pregnancy have the lowest risk of perinatal HIV transmission.[2]

Vertical HIV transmission to newborns during the peripartum or while breastfeeding has been linked to maternal HIV medication resistance, viral load, and CD4 cell counts.

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Epidemiology[edit | edit source]

According to the Joint United Nations Programme on HIV/AIDS (UNAIDS), approximately 37.7 million people worldwide were infected with HIV in 2020, with 1.5 million new infections. Women and girls accounted for 63% of all new HIV infections in Sub-Saharan Africa. New HIV infections in children have dropped by 53%, from 320 000 [210 000–510 000] in 2010 to 150 000 [100 000–240 000] in 2020.[5]

85% of pregnant women living with HIV had access to antiretroviral medicines to prevent transmission of HIV to their child in 2020.[5]

Mother to Child Transmission of HIV[edit | edit source]

Perinatal Transmission[edit | edit source]

This can occur during pregnancy and/or delivery.

Postnatal Transmission[edit | edit source]

This can occur after delivery during breastfeeding through the breastmilk.

Antiretroviral Drugs in Pregnancy[edit | edit source]

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Dolutegravir (DTG) is the preferred antiretroviral (ARV) medication for pregnant women, and women trying to conceive. This follows evidence that Dolutegravir is associated with a low risk of neural tube defects, as well as long-term viral load reduction, which is critical for maternal health and preventing perinatal HIV transmission.[2]

Sub Heading 3[edit | edit source]

Resources[edit | edit source]

References[edit | edit source]

  1. WHO. Antiretroviral drugs for treating pregnant women and preventing HIV infection in infants: recommendations for a public health approach. Geneva: WHO; 2010.
  2. 2.0 2.1 Panel on Treatment of Pregnant Women with HIV Infection and Prevention of Perinatal Transmission. Recommendations for the Use of Antiretroviral Drugs in Pregnant Women with HIV Infection and Interventions to Reduce Perinatal HIV Transmission in the United States. Available from https://clinicalinfo.hiv.gov/en/guidelines/perinatal/whats-new-guidelines Accessed 8th December 2021
  3. Ceejay L Boyce, Tatiana Sils, Daisy Ko, Annie Wong-on-Wing, Ingrid A Beck, Sheila M Styrchak, Patricia DeMarrais, Camlin Tierney, Lynda Stranix-Chibanda, Patricia M Flynn, Taha E Taha, Maxensia Owor, Mary Glenn Fowler, Lisa M Frenkel, IMPAACT 1077BF Promoting Maternal and Infant Survival Everywhere (PROMISE) Study Team, Maternal Human Immunodeficiency Virus (HIV) Drug Resistance Is Associated With Vertical Transmission and Is Prevalent in Infected Infants, Clinical Infectious Diseases, 2021
  4. HIV / AIDS and Pregnancy - What You Need To Know. Available from https://www.youtube.com/watch?v=bZpbrYtLhRM
  5. 5.0 5.1 Global HIV & AIDS statistics — Fact sheet | UNAIDS https://www.unaids.org/en/resources/fact-sheet (accessed 16/12/2021)