Friday, August 14, 2009

HIV & PREGNANCY

  • HIV is an RNA herpes virus that is spread by infected body secretions.
  • The most common ways of transmission are sharing contaminated needles, having sexual intercourse with an infected partner and perinatal transmission.
  • The clinical course from HIV to AIDS is a gradual but relentless immunosupression during a period of year, resulting in death caused by overwhelming infection from opportunistic diseases. Progression from HIV to AIDS in infants is more rapid than in adults.
  • Neonates of HIV infected women have a 13-52% chance of acquiring HIV from the mother.
  • The major route of vertical transmission is contact with the infected genital secretion at the time of vaginal delivery.
  • Neonates born from HIV positive mother will have positive HIV tests from passage of trans placental passive IgG.
  • All HIV- positive pregnant women are recommended anti viral prophylaxis(AZT), which is continued from 14 weeks' gestation throughout pregnancy, including delivery.
  • The vertical transmission rate is 30%, without maternal azidothymidine (AZT) prophylaxis. AZT prophylaxis has reduced the infection rate to 10%, with vaginal delivery.
  • Pregnant women with low CD4 count and high RNA viral loads are given multidrug antiviral regimens.
  • The currently offered mode of delivery is cesarean section to HIV-positive women.
  • Perinatal transmission is increasing globally as a direct result of the increase in number of HIV infection among women of child bearing age. Global precautions is to pay careful attention in handling all body fluids.
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