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美国孕期HIV感染的管理:更新的循证建议及未来潜在实践

Management of HIV Infection during Pregnancy in the United States: Updated Evidence-Based Recommendations and Future Potential Practices.

作者信息

Rimawi Bassam H, Haddad Lisa, Badell Martina L, Chakraborty Rana

机构信息

School of Medicine, Department of Gynecology and Obstetrics, Division of Maternal Fetal Medicine and Reproductive Infectious Diseases, Emory University, 550 Peachtree Street, Atlanta, GA 30308, USA.

School of Medicine, Department of Gynecology and Obstetrics, Division of Family Planning, Emory University, 550 Peachtree Street, Atlanta, GA 30308, USA.

出版信息

Infect Dis Obstet Gynecol. 2016;2016:7594306. doi: 10.1155/2016/7594306. Epub 2016 Jul 18.

Abstract

All HIV-infected women contemplating pregnancy should initiate combination antiretroviral therapy (cART), with a goal to achieve a maternal serum HIV RNA viral load beneath the laboratory level of detection prior to conceiving, as well as throughout their pregnancy. Successfully identifying HIV infection during pregnancy through screening tests is essential in order to prevent in utero and intrapartum transmission of HIV. Perinatal HIV transmission can be less than 1% when effective cART, associated with virologic suppression of HIV, is given during the ante-, intra-, and postpartum periods. Perinatal HIV guidelines, developed by organizations such as the World Health Organization, American College of Obstetricians and Gynecologists, and the US Department of Health and Human Services, are constantly evolving, and hence the aim of our review is to provide a useful concise review for medical providers caring for HIV-infected pregnant women, summarizing the latest and current recommendations in the United States.

摘要

所有考虑怀孕的感染艾滋病毒的妇女都应开始联合抗逆转录病毒疗法(cART),目标是在怀孕前以及整个孕期将母体血清艾滋病毒RNA病毒载量降至实验室检测水平以下。通过筛查试验在孕期成功识别艾滋病毒感染对于预防子宫内和分娩时的艾滋病毒传播至关重要。当在产前、产时和产后给予有效的cART(与艾滋病毒的病毒学抑制相关)时,围产期艾滋病毒传播率可低于1%。由世界卫生组织、美国妇产科医师学会和美国卫生与公众服务部等组织制定的围产期艾滋病毒指南在不断演变,因此我们综述的目的是为照顾感染艾滋病毒孕妇的医疗服务提供者提供一份有用的简要综述,总结美国最新和当前的建议。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/59cf/4967680/b0a6e513e65b/IDOG2016-7594306.001.jpg

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