Matthew Givens1, Sarah K Dotters-Katz2, Elizabeth Stringer3, Lisa Rahangdale4, Jeffrey A Kuller5. 1. Resident, Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC. 2. Assistant Professor, Division of Maternal Fetal Medicine, Duke University, Durham, NC. 3. Associate Professor, Division of Maternal Fetal Medicine. 4. Associate Professor, Division of General Obstetrics & Gynecology, University of North Carolina, Chapel Hill, NC. 5. Professor, Division of Maternal Fetal Medicine, Duke University, Durham, NC.
Abstract
IMPORTANCE: There are approximately 284,500 adolescent and adult women living with human immunodeficiency virus (HIV) in the United States. It is estimated that approximately 8500 of these women give birth annually. While the rate of perinatal transmission in the United States has decreased by more than 90% since the early 1990s, potentially preventable HIV transmission events still occur and cause significant morbidity and mortality. OBJECTIVE: The aim of this review was to summarize the current data regarding perinatal HIV transmission timing and risk factors, current management recommendations, and implications of timing of transmission on patient management. EVIDENCE ACQUISITION: Literature review. RESULTS: This review reiterates that the risk of perinatal HIV transmission can be reduced to very low levels by following current recommendations for screening for HIV in all pregnant women and properly treating HIV-infected mothers, as well as using evidence-based labor management practices. CONCLUSIONS AND RELEVANCE: Familiarity with the pathogenesis of HIV transmission is important for obstetric care providers to appropriately manage HIV-infected women in pregnancy, intrapartum, and the postpartum period.
IMPORTANCE: There are approximately 284,500 adolescent and adult women living with human immunodeficiency virus (HIV) in the United States. It is estimated that approximately 8500 of these women give birth annually. While the rate of perinatal transmission in the United States has decreased by more than 90% since the early 1990s, potentially preventable HIV transmission events still occur and cause significant morbidity and mortality. OBJECTIVE: The aim of this review was to summarize the current data regarding perinatal HIV transmission timing and risk factors, current management recommendations, and implications of timing of transmission on patient management. EVIDENCE ACQUISITION: Literature review. RESULTS: This review reiterates that the risk of perinatal HIV transmission can be reduced to very low levels by following current recommendations for screening for HIV in all pregnant women and properly treating HIV-infected mothers, as well as using evidence-based labor management practices. CONCLUSIONS AND RELEVANCE: Familiarity with the pathogenesis of HIV transmission is important for obstetric care providers to appropriately manage HIV-infected women in pregnancy, intrapartum, and the postpartum period.