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HIV in Pregnancy

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Contemporary Obstetrics and Gynecology for Developing Countries

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Abstract

HIV can be acquired and transmitted during pregnancy. The adverse outcomes of HIV infection in pregnancy include spontaneous miscarriage, preterm delivery, intrauterine growth restriction, low birth weight and maternal mortality. Another major concern about HIV infection in pregnancy is the risk of transmission of the virus to the baby in utero, during delivery and in the postpartum period through breast milk. There is global call for the elimination of mother-to-child transmission of HIV. The application of current recommendations in the management of HIV-positive pregnant women has resulted in significant reduction in perinatal transmission risk of HIV from the base line value of 25–45% to less than 2% in many developed countries.

This chapter discusses the epidemiology of HIV, risk factors for HIV infection, mother-to-child transmission of HIV, prevention and treatment of HIV infection. The importance of HIV testing and counselling in pregnancy is highlighted. This chapter recommends that persons living with HIV infection should be provided reproductive health services including contraception until her health situation is optimised and safe for pregnancy. This chapter also recommends that all HIV-positive pregnant women should receive professional antenatal, intrapartum and postpartum care. Expert care for the HIV-exposed infant is also recommended for a successful outcome.

Note: Dolutegravir-based regimen should be avoided by women during preconception period and in first trimester of pregnancy due to risk of neural tube defect in their babies.

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Abbreviations

3TC:

Lamivudine 300 mg OD

ART:

Antiretroviral therapy

ATV/r:

Atazanavir/ritonavir 300 mg + 100 mg

AZT:

Azidothymidine or zidovudine – ZDV 300 mg BD

DRV/r:

Darunavir + ritonavir 800 mg +100 m OD

DTG:

Dolutegravir 50 mg OD

EFV:

Efavirenz 600 mg OD

FTC:

Emtricitabine 200 mg OD

LPV/r:

Lopinavir/ritonavir 400 mg + 100 mg

NRTIs:

Nucleoside reverse transcriptase inhibitors

NVP:

Nevirapine 200 mg OD for 14 days, then 200 mg BD

RAL:

Raltegravir 400 mg OD

TDF:

Tenofovir disoproxil fumarate 300 mg OD

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Authors and Affiliations

  1. Reproductive Medicine and Endocrinology Unit, Department of Obstetrics & Gynaecology, National Hospital, Abuja, Nigeria

    Chris Ovoroyeguono Agboghoroma

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  1. Chris Ovoroyeguono Agboghoroma
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Editors and Affiliations

  1. Centre of Excellence in Reproductive Health Innovation, Department of Obstetrics and Gynaecology, University of Benin, Benin City, Nigeria

    Friday Okonofua

  2. College of Health Sciences, Chicago State University, Chicago, IL, USA

    Joseph A. Balogun

  3. Roswell Park Cancer Institute, Buffalo, NY, USA

    Kunle Odunsi

  4. Clinical Obstetrics and Gynaecology, Weil Cornell Medicine, Doha, Qatar

    Victor N. Chilaka

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Agboghoroma, C.O. (2021). HIV in Pregnancy. In: Okonofua, F., Balogun, J.A., Odunsi, K., Chilaka, V.N. (eds) Contemporary Obstetrics and Gynecology for Developing Countries . Springer, Cham. https://doi.org/10.1007/978-3-030-75385-6_35

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  • DOI: https://doi.org/10.1007/978-3-030-75385-6_35

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