facts about perinatal HIV - darkhorse

[ArchivalUser]

In the United States, the standard recommendation for infant prophylaxis in the absence
of maternal antenatal and intrapartum therapy remains 6 weeks of infant ZDV.

[ArchivalUser]

For nonbreastfeeding women in resource-rich countries, the addition of single-dose NVP did not offer significant benefit in the setting of potent combination antiretroviral therapy throughout pregnancy and very low viral load at the time of delivery

[ArchivalUser]

Antiretroviral prophylaxis to prevent perinatal HIV transmission should be
provided to all HIV-infected women,regardless of HIV RNA copy number.

[ArchivalUser]

If a pregnant woman presents in labor with incomplete HIV testing (e.g., undocumented HIV test results or only one rather than two HIV tests), then she should be screened
with a rapid HIV test on the labor and delivery unit

[ArchivalUser]

If results from either conventional or rapid HIV testing are positive, then the woman should receive interventions to reduce perinatal HIV transmission, including immediate
initiation of appropriate antiretroviral prophylaxis and consideration of elective cesarean delivery according to established guidelines

[ArchivalUser]

Three-drug combination regimens including nelfinavir have had extensive use in pregnancy. However, in September 2007, the U.S. manufacturer, Pfizer, sent a letter to
providers regarding the presence of ethyl methane sulfonate (EMS), a process-related impurity, in Viracept (nelfinavir mesylate) available in the United States. Data from
animal studies indicate EMS is teratogenic, mutagenic, and carcinogenic; however, no data from humans exist and there are no data on the ability of EMS to cross the
placenta.

[ArchivalUser]

Pregnant women who need to begin antiretroviral therapy or prophylaxis should not be offered regimens containing nelfinavir until further notice, but rather begin an alternative antiretroviral regimen.

[ArchivalUser]

For pregnant women with no alternative treatment options, the risk-benefit ratio remains favorable for the continued use of nelfinavir. In such women, the critical importance of maintaining maternal health status and preventing mother-to-child transmission
outweighs the potential risks.

[ArchivalUser]

the other recommended protease inhibitor for use in pregnant women is lopinavir/
ritonavir. Recommended alternative protease inhibitors include indinavir (boosted with ritonavir) or saquinavir (boosted with ritonavir).

[ArchivalUser]

HIV infected women receiving antiretroviral therapy at the time of conception whose pregnancy is identified after the first trimester should always continue therapy.