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. If untreated, HIV progresses to acquired immunodeficiency syndrome (AIDS), which is almost surely fatal. Approximately 33 million people worldwide are infected with HIV [1]. HIV is transmitted by multiple methods; sexually, via contact with contaminated blood, and from mother to child in utero being the primary ones [2].

At least half of the global HIV+ population are female. Women of child-bearing age must consider their options for preventing viral transmission to their children. Mother to child transmission (MTCT) has been a topic of great research and, by following guidelines, it is now possible for an HIV+ mother can have an HIV- child. In well-resourced countries the rate of MTCT is <1% [3]. In poorly-resourced countries the rate of MTCT is decreasing but still hovers around 35% [5]. Worldwide access to pharmaceuticals and healthcare are critical in reducing MTCT. Eliminating MTCT is a priority as it makes possible ending the perpetuation HIV/AIDS between generations and brings us a large step closer to ending the HIV epidemic.

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 in regards to 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. Drugs considered suitable for HIV+ patients may not be safe for a pregnant women.

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.

[5] Onyango, Rosebella O. 2006. Mother-To-Child Transmission of HIV/AIDS. Towards Unity for Health Women and Health Taskforce. Maseno University, Maseno Kenya.

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