Important note: Information in this article was accurate in 1994. The state of the art may have changed since the publication date.
Human immunodeficiency virus/acquired immunodeficiency syndrome in pregnant women [published erratum appears in Ann Epidemiol 1993 Nov;3(6):653-5]
Ann Epidemiol. 1992 Nov;2(6):773-803. Unique Identifier : AIDSLINE MED/94101189 Vermund SH; Galbraith MA; Ebner SC; Sheon AR; Kaslow RA; Division of AIDS, National Institute of Allergy and Infectious; Diseases, National Institutes of Health, Bethesda, MD 20892.
Abstract:
A pregnant woman experiences selective immunosuppression as a physiologic response to the presence of a genetically heterologous fetus. Case reports early in the acquired immunodeficiency syndrome (AIDS) epidemic suggested that adverse human immunodeficiency virus (HIV)-related clinical outcomes might be causally associated with pregnancy. A review of relevant published data indicates that: (1) Adverse clinical outcomes of pregnancy are common among HIV-infected pregnant women, but no studies to date have fully disentangled the many confounding factors. (2) HIV-related complications are common in pregnancy only among immunosuppressed (< 300 CD4+ cells/mm3) women. (3) The distinct effect of pregnancy on the expression of HIV infection cannot be evaluated in the absence of appropriately controlled observations. (4) Cofactors for perinatal transmission are poorly understood. (5) Research into the motives for reproductive decisions and behaviors is of critical importance for improving our health education and outreach efforts for high-risk women. (6) Adequate clinical treatment and prophylactic health care services must be made easily accessible and available to women at high risk of HIV disease. (7) Treatment with available antiviral and anti-Pneumocystis drugs is advisable for HIV-infected pregnant women with fewer than 300 to 350 CD4+ cells/mm3, though data to definitively guide therapeutic decision making are not available. (8) Large multicenter studies are needed to recruit patients and to retain them in sufficient numbers, allowing for better evaluation of the many variables determining clinical outcomes for HIV-infected mothers and their infants. The natural history of HIV in pregnant women must be studied to facilitate clinical decision making, and to design and implement interventions, including prevention (behavior change, vaccines) and treatment (chemotherapy, immunotherapy).
Keywords: *Acquired Immunodeficiency Syndrome/CONGENITAL/IMMUNOLOGY/THERAPY/ TRANSMISSION Female Human Infant, Newborn Pregnancy *Pregnancy Complications, Infectious/IMMUNOLOGY/THERAPY Pregnancy Outcome Risk Factors JOURNAL ARTICLE REVIEW REVIEW, TUTORIAL 940430
M9440882
AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.
Important note: Information in this article was accurate in 1994. The state of the art may have changed since the publication date.
