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Recent developments in HIV and women's health
Author(s) -
Kelly Brenda,
Morrison Joanne,
Hurley Pauline
Publication year - 2008
Publication title -
the obstetrician and gynaecologist
Language(s) - English
Resource type - Journals
eISSN - 1744-4667
pISSN - 1467-2561
DOI - 10.1576/toag.10.1.042.27377
Subject(s) - medicine , transmission (telecommunications) , caesarean section , cervical intraepithelial neoplasia , viral load , obstetrics , hormonal contraception , pregnancy , adverse effect , human immunodeficiency virus (hiv) , gynecology , intensive care medicine , pediatrics , population , cervical cancer , immunology , family planning , cancer , environmental health , biology , electrical engineering , research methodology , genetics , engineering
Key content• In the UK, the proportion of HIV‐positive pregnant women diagnosed before delivery is around 95%. • The benefits of highly active antiretroviral therapy (HAART) in reducing mother‐to‐child transmission are undisputed; however, there are potentially adverse effects on maternal and fetal/neonatal health. • Vaginal delivery may be considered for HIV‐positive pregnant women with undetectable viral loads who are on HAART. • Hormonal contraception can be affected by drug–drug interactions with HAART or nonantiretroviral medication that HIV‐positive women may be taking. • Although HAART can alter the natural history of cervical intraepithelial neoplasia (CIN), annual cervical cytology is still recommended.Learning objectives• To be aware of the different types of HAART, their use and associated maternal, fetal and neonatal toxicities. • To be able to critically evaluate the place of prelabour elective caesarean section in light of recent developments in viral load testing and HAART. • To be aware of potential drug–drug interactions that can reduce the efficacy of hormonal contraception in HIV‐positive women. • To appreciate the potential impact of HAART and the recently developed human papillomavirus vaccines on the natural history of CIN in HIV‐positive women. • To know where to find up‐to‐date information on drug–drug interactions and clinical vaccine trials relating to HIV.Ethical issues• Clear communication about the potential risks and benefits of strategies to reduce mother‐to‐child transmission is critical to enable HIV‐positive pregnant women to reach informed decisions about their care.Please cite this article as: Kelly B, Morrison J, Hurley P. Recent developments in HIV and women's health. The Obstetrician & Gynaecologist 2008;10:42–48.