Resident, Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC.
Assistant Professor, Division of Maternal Fetal Medicine, Duke University, Durham, NC.
Obstet Gynecol Surv. 2018 Jul;73(7):423-432. doi: 10.1097/OGX.0000000000000581.
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.
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.
Literature review.
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.
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.
在美国,大约有 284500 名青少年和成年女性携带人类免疫缺陷病毒(HIV)。据估计,每年大约有 8500 名妇女分娩。虽然自 20 世纪 90 年代初以来,美国的围产期传播率已经下降了 90%以上,但仍有可能发生可预防的 HIV 传播事件,导致严重的发病率和死亡率。
本综述旨在总结目前关于围产期 HIV 传播时间和风险因素的数据,当前的管理建议,以及传播时间对患者管理的影响。
文献回顾。
本综述重申,通过对所有孕妇进行 HIV 筛查、对 HIV 感染母亲进行适当治疗以及采用循证分娩管理实践,可以将围产期 HIV 传播的风险降低到非常低的水平。
熟悉 HIV 传播的发病机制对于产科护理提供者来说非常重要,这有助于他们在妊娠、分娩和产后期间对 HIV 感染的妇女进行适当的管理。