Section 2: Treatment of women planning pregnancy or pregnant


Percentage of patients pregnant when diagnosed with HIV can be high

1. Torrone EA, et al. Public Health Rep 2010;125:96–102
2. Floridia M, et al. Epidemiol Infect 2006;134:1120–7
3. Aebi-Popp K, et al. J Perinat Med 2010; 38: 353–8
4. Thorne C, et al. IAS 2009. Presentation TUAC103



Median CD4 cell count at HIV diagnosis of pregnant and non-pregnant women: UK 2000–2009

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Health Protection Agency. Available at http://www.hpa.org.uk/web/HPAwebFile/HPAweb_C/1296681720660. Accessed March 2011



Both mother and infant have poorer outcomes with late-stage diagnosish

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* Women diagnosed through antenatal HIV testing in index pregnancy Thorne C, et al. IAS 2009. Presentation TUAC103



Increasing numbers of antenatal HIV tests performed in some countries, but numbers are still unsatisfactory

Number of HIV tests performed during prenatal counselling increased between 2001 and 2007 from 59.6% to 76.7% in a retrospective cohort analysis of 12,873 deliveries at a German hospital1

1. Kost BP, et al. Arch Gynecol Obstet 2010 Aug 18 [Epub ahead of print].
2. Health Protection Agency. Available at: http://www.hpa.org.uk/web/HPAwebFile/HPAweb_C/1287145367237. Accessed March 2011



Opt-out policies vary across Europe

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Data includes Denmark which now offers opt-out testing; †Germany currently has an opt-in policy, but opt-out implemented in practice. Available at: http://hivbook.com/2-hiv-testing.html. Accessed March 2011 ;1. Available at: http://www.bhiva.org/documents/Guidelines/Testing/GlinesHIVTest08.pdf. Accessed March 2011; 2. NCCID. Routine (opt-out) HIV screening. Available at: http://www.nccid.ca/en/files/Evidence_reviews/Routine_HIV_ Screening_Eng.pdf. Accessed March 2011; 3. Adapted from Mounier-Jack S, et al. HIV Medicine 2008; 9 (suppl 2);13–9; 4. Deblonde J, et al. Eur J Public Health 2007;17:414-8. 5. Available from: http://www.unaids.org/en/dataanalysis/monitoringcountryprogress/2010progressreportssubmitted Bycountries/ireland_2010_country_progress_report_en.pdf Accessed April 2011



EACS: Recommendations for treatment of HIV-positive pregnant women

Pregnant women should be monitored every month and as close as possible to the predicted delivery date

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ARVs used during pregnancy should be selected only if potential benefit justifies the potential risk2

EACS guidelines. Available at: http://www.europeanaidsclinicalsociety.org/guidelinespdf/1_Treatment_of_HIV_Infected_Adults.pdf. Accessed March 2011; 2. SmPCs. Available at http://www.ema.europa.eu Accessed March 2011



Women with a baseline VL >100,000 copies/mL should commence ART as early as possible in the second trimester1


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ARVs used during pregnancy should be selected only if potential benefit justifies the potential risk2

1. Read PJ, et al. CROI 2010. Poster 896; 2. SmPCs. Available at http://www.ema.europa.eu Accessed March 2011



Considerations when choosing ART for pregnant women with HIV1

ARVs used during pregnancy should be selected only if potential benefit justifies the potential risk2

1. DHHS Perinatal Guidelines. Available at http://aidsinfo.nih.gov/contentfiles/PerinatalGL.pdf. Accessed March 2011; 2. SmPCs. Available at http://www.ema.europa.eu Accessed March 2011



Guidelines and recommendations for HIV-infected pregnant women: Europe and USA

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Guidelines and recommendations for HIV-infected pregnant women: Europe and USA

1. EACS general treatment guidelines 2011. Available at: http://www.europeanaidsclinicalsociety.org/guidelines.asp . Accessed March 2011; 2. DHHS pregnant women guidelines 2010. Available at: http://aidsinfo.nih.gov/contentfiles/PerinatalGL_PDA.pdf. Accessed March 2011; 3. SmPCs. Available at http://www.ema.europa.eu Accessed March 2011