HIV+ Pregnant Women and Antiretroviral Treatment

A Viral Biorealm page on the family HIV+ Pregnant Women and Antiretroviral Treatment

The human immunodeficiency virus (HIV) has been a global epidemic for over 30 years. Approximately 35 million worldwide are infected with HIV [1]. If untreated, HIV progresses to acquired immunodeficiency syndrome (AIDS), which is almost surely fatal. HIV is transmitted by multiple methods; sexually, via contact with contaminated blood, and from mother to child in utero are the primary methods [2]. Mother to child transmission (MTCT) has been a topic of great research and, by following guidelines, it is now nearly guaranteed that an HIV+ mother can have an HIV- child. In well-resourced countries the rate of MTCT is <1% [3].

There are five main criteria for a successful HIV- pregnancy: 1) antiretroviral therapy for the mother, 2) semen washing if the father is HIV+, 3) alternative insemination, 4) specialized obstetrical care (usually including a caesarian section), and 5) formula feeding. Access to all five of these criteria is what determines a low rate of MTCT. Of these criteria, antiretroviral therapy for the mother is the most effective in reducing MTCT [4].

HIV+ mother with her HIV- child.[1].

Available Antiretroviral Drugs

Even more than for other HIV+ patients, antiretroviral regimens for pregnant women must be especially carefully considered. The woman will be on ARV's for the duration of her pregnancy, exposing the vulnerable and developing fetus to a high concentration of drugs for a prolonged period of time.

Zidovudine

Newly Available ARVs

Sociological Differences in Treatment Objectives

Side Effects for the Mother

Side Effects for the Child

Gallus gallus domesticus showing obvious signs of late-stage CAV infection. [2].

The Future of HIV+ Pregnancy Treatment

Virion Structure of Chicken Anemia Virus

Reproductive Cycle of CAV in a Host Cell

Viral Ecology & Pathology

Immunopathogenesis of Chicken Anemia Virus. Hemocytoblasts in the bone marrow, and T cell progenitors in the thymus are the CAV's key targets. [3].

References

[1] Barton-Knott, Sophie. 2011. Nearly 50% of People Who are Eligible for Antiretroviral Therapy Now Have Access to Lifesaving Treatment. UNAIDS press release. http://www.unaids.org/en/resources/presscentre/pressreleaseandstatementarchive/2011/november/20111121wad2011report/.

[2] Centers for Disease Control and Prevention. 2010. HIV Transmission. http://www.cdc.gov/hiv/resources/qa/transmission.htm.

[3] Foster, C., H. Lyall, B, Olmscheid, G. Pearce, S. Zhang and D. Gibb. 2009. Tenofovir Disproxil Fumarate in Pregnancy and Prevention of Mother-to-Child-Transmission of HIV-1: Is it Time to Move on From Zidovudine? HIV Medicine. 10: 397-406.

[4] Giaquinto, C., E. Ruga, D. Rossi, I. Grosch-Worner, J. Mok, I. Jose, I. Bates, F. Hawkins, C. Guevara, J. Pena, J. Garcia, J. Lopez, M. Garcia-Rodriguez, F. Asensi-Botet, M. Otero and D. Perez-Tamarit. 2005. Mother-to-Child-Transmission of HIV Infection in the Era of Highly Active Antiretroviral Therapy. Clinical Infectious Diseases. 40: 458-465.

Page authored by Ellen Gaglione for BIOL 375 Virology, September 2010