Overview
Natural history, epidemiology, testing, and treatment Infection with HIV results in an initial acute viral illness followed by a chronic decline in cellular immunity due to progressive depletion of CD4-positive T-lymphocytes, and eventually resulting in one or more illnesses defined as the acquired immune deficiency syndrome (AIDS)
In gynaecological practice
- Include cervical cancer (cervical cytology is recommended)
- Cervical intraepithelial neoplasia (CIN).
- Vaginal intraepithelial neoplasia.
The notification of partner and children is crucial as it improves outcomes and prevents onward transmission.
Management of the HIV-positive Mother and Her Child
Effective Antiretroviral Therapy
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Effective antiretroviral therapy.
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Transmission (MTCT) occurs during birth or breastfeeding. Intrauterine infection is unusual and due to intervention (for example, amniocentesis).
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Delivery by prelabour caesarean section further reduces MTCT rates when the HIV viral load is detectable.
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Obstetric risk factors that increase the transmission include:
- Prolonged rupture of membranes
- Procedures that breach the infant’s skin (such as fetal scalp electrodes)
- Increase maternal blood in the birth canal.
These risks are reduced by effective control of maternal HIV
Formula feeding is safe; this is preferable.