31. HIV Infection

  1. John T. Queenan MD2,
  2. Catherine Y. Spong MD3 and
  3. Charles J. Lockwood MD4
  1. Howard L. Minkoff MD

Published Online: 4 JAN 2012

DOI: 10.1002/9781119963783.ch31

Queenan's Management of High-Risk Pregnancy: An Evidence-Based Approach, Sixth Edition

Queenan's Management of High-Risk Pregnancy: An Evidence-Based Approach, Sixth Edition

How to Cite

Minkoff, H. L. (2012) HIV Infection, in Queenan's Management of High-Risk Pregnancy: An Evidence-Based Approach, Sixth Edition (eds J. T. Queenan, C. Y. Spong and C. J. Lockwood), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781119963783.ch31

Editor Information

  1. 2

    Department of Obstetrics and Gynecology, Georgetown University School of Medicine, Washington, DC, USA

  2. 3

    Bethesda, MD, USA

  3. 4

    Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, USA

Author Information

  1. Department of Obstetrics and Gynecology, Maimonides Medical Center, New York, NY, USA

Publication History

  1. Published Online: 4 JAN 2012
  2. Published Print: 24 FEB 2012

ISBN Information

Print ISBN: 9780470655764

Online ISBN: 9781119963783

SEARCH

Keywords:

  • HIV infection;
  • HIV epidemic, epidemiology and pathophysiology;
  • care of HIV-infected women;
  • identifying the infected, reducing HIV and drug toxicity;
  • ACOG, and “opt-out” process, HIV testing “routinized”;
  • antigen detection from virus itself;
  • ELISA confirmed by Western blot, antibodies to virus in sera;
  • posttest counseling of seropositive women;
  • antiretroviral drug use, in pregnant HIV-infected women;
  • HIV-infected women care, controversial areas of law, ethics

Summary

The HIV epidemic is now 30 years old, with well-defined epidemiology and pathophysiology, and with many effective therapeutic regimens available for use. However, the epidemic is far from contained. In many parts of the world, most notably sub-Saharan Africa where about 90% of the world's 500,000 infected infants are born annually, the disease continues to exact a frightening toll. There are cities in the US (e.g. Washington, DC) where the prevalence rivals that seen in several endemic countries. An increasing nimber of infected individuals are women, the overwhelming majority of whom are of reproductive age. Thus, obstetricians worldwide continue to play a pivotal role. While the care of HIV-infected women is more successful than ever and the rates of mother-to-child transmission of HIV are lower than ever (at least in communities with access to therapy), management is also more complex than ever. This chapter is designed to provide guidance to the obstetrician who must identify and treat infected women, and act to reduce rates of HIV transmission and drug toxicity while optimizing pregnant women's health.