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Chapter 62 - Human Immunodeficiency Virus Infection in Pregnancy

from Section 11 - Infectious Conditions in Pregnancy

Published online by Cambridge University Press:  23 February 2023

By
Erica Hardy  and
Amira El-Messidi
Edited by
Amira El-Messidi  and
Alan D. Cameron
Amira El-Messidi
Affiliation:
McGill University, Montréal
Alan D. Cameron
Affiliation:
University of Glasgow
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Summary

A new patient presents for consultation and transfer of care to your high-risk obstetrics unit at a tertiary center. She is a healthy 22-year-old primigravida at 14+3 weeks’ gestation with an incidentally positive test for human immunodeficiency virus (HIV) on routine prenatal testing. A copy of the original laboratory report has been provided to you. The patient is aware of the results. Referral to a virologist has also been instigated. Her first-trimester sonogram and aneuploidy screen were unremarkable. She has no obstetric complaints.

Keywords

Human immunodeficiency virus, prenatal diagnosis, pregnancyInvestigations, fourth-generation immunoassayComorbiditiesSocial health measuresCombined antiretroviral therapyAntepartum, intrapartum, postpartum managementPerinatal risks, complications, maternal-fetal morbidity, adverse outcomeInvasive diagnostic procedures, considerationsObstetric deliveryMother-to-child, perinatal transmissionContraceptionBreastfeeding
Type
Chapter
Information
OSCEs in Obstetrics and Maternal-Fetal Medicine
An Evidence-Based Approach
 , pp. 796 - 808
Publisher: Cambridge University Press
Print publication year: 2023

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References

Suggested Readings

American College of Obstetricians and Gynecologists’ Committee on Practice Bulletins–Gynecology. Practice Bulletin No. 167: Gynecologic care for women and adolescents with human immunodeficiency virus. Obstet Gynecol. 2016;128(4):e89–e110.Google Scholar
Bailey, H, Zash, R, Rasi, V, et al. HIV treatment in pregnancy. Lancet HIV. 2018;5(8):e457–e467.CrossRefGoogle ScholarPubMed
Centers for Disease Control and Prevention, Association of Public Health Laboratories. Laboratory testing for the diagnosis of HIV infection: updated recommendations. Atlanta (GA), Silver Spring (MD). CDC, APHL; 2014. Available at http://stacks.cdc.gov/view/cdc/23447. Accessed November 8, 2020.Google Scholar
Committee on Obstetric Practice; HIV Expert Work Group. ACOG Committee Opinion No. 751: labor and delivery management of women with human immunodeficiency virus infection. Obstet Gynecol. 2018;132(3):e131–e137.Google Scholar
Floridia, M, Masuelli, G, Meloni, A, et al. Amniocentesis and chorionic villus sampling in HIV-infected pregnant women: a multicentre case series. BJOG. 2017;124(8):1218–1223.Google Scholar
Gibson, KS, Toner, LE. Society for Maternal-Fetal Medicine (SMFM) Special Statement: Updated checklists for pregnancy management in persons with HIV. Am J Obstet Gynecol. 2020;223(5):B6–B11.CrossRefGoogle Scholar
Gilleece, DY, Tariq, DS, Bamford, DA, et al. British HIV Association guidelines for the management of HIV in pregnancy and postpartum 2018. HIV Med. 2019;20(Suppl 3):s2–s85. Available at www.bhiva.org/pregnancy-guidelines. Accessed October 22, 2020.CrossRefGoogle ScholarPubMed
Irshad, U, Mahdy, H, Tonismae, T. HIV In Pregnancy. In StatPearls. Treasure Island, FL: StatPearls Publishing; 2020.Google Scholar
Loutfy, M, Kennedy, VL, Poliquin, V, et al. No. 354 – Canadian HIV pregnancy planning guidelines. J Obstet Gynaecol Can. 2018;40(1):94–114.CrossRefGoogle ScholarPubMed
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 at https://clinicalinfo.hiv.gov/sites/default/files/guidelines/documents/Peri_Recommendations.pdf. Accessed November 7, 2020.Google Scholar

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