Open AccessJournal Article
U.S. Public Health Service Task Force recommendations for use of antiretroviral drugs in pregnant HIV-1-infected women for maternal health and interventions to reduce perinatal HIV-1 transmission in the United States.
TLDR
These recommendations update the February 4,2002, guidelines for the use of zidovudine (ZDV) to reduce the risk for perinatal human immunodeficiency virus type 1 (HIV-1) transmission and include a recommendation that ZDV chemoprophylaxis should be incorporated into the antiretroviral regimen.Abstract:
These recommendations update the February 4,2002, guidelines developed by the Public Health Service for the use of zidovudine (ZDV) to reduce the risk for perinatal human immunodeficiency virus type 1 (HIV-1) transmission. This report provides healthcare providers with information for discussion with HIV-1-infected pregnant women to enable such women to make an informed decision regarding the use of antiretroviral drugs during pregnancy and use of elective cesarean delivery to reduce perinatal HIV-1 transmission. Various circumstances that commonly occur in clinical practice are presented, and the factors influencing treatment considerations are highlighted in this report. The Perinatal HIV Guidelines Working Group recognizes that strategies to prevent perinatal transmission and concepts related to management of HIV disease in pregnant women are rapidly evolving and will continually review new data and provide regular updates to the guidelines. The most recent information is available from the HIV/AIDS Treatment Information Service (available at http.//www.hivatis.org). In February 1994, the results of Pediatric AIDS Clinical Trials Group (PACTG) Protocol 076 documented that ZDV chemoprophylaxis could reduce perinatal HIV-1 transmission by nearly 70%. Epidemiologic data have since confirmed the efficacy of ZDV for reduction of perinatal transmission and have extended this efficacy to children of women with advanced disease, low CD4+ T-lymphocyte counts, and prior ZDV therapy. Additionally, substantial advances have been made in the understanding of the pathogenesis of HIV-1 infection and in the treatment and monitoring of persons with HIV-1 disease. These advances have resulted in changes in standard antiretroviral therapy for HIV-1-infected adults. More aggressive combination drug regimens that maximally suppress viral replication are now recommended. Although considerations associated with pregnancy may affect decisions regarding timing and choice of therapy pregnancy is not a reason to defer standard therapy. Use of antiretroviral drugs in pregnancy requires unique considerations, including the possible need to alter dosage as a result of physiologic changes associated with pregnancy the potential for adverse short- or long-term effects on the fetus and newborn, and the effectiveness of the drugs in reducing the risk for perinatal transmission. Data to address many of these considerations are not yet available. Therefore, offering antiretroviral therapy to HIV-1-infected women during pregnancy, whether primarily for HIV-1 infection, for reduction of perinatal transmission, or for both purposes, should be accompanied by a discussion of the known and unknown short- and long-term benefits and risks of such therapy to infected women and their infants. Standard antiretroviral therapy should be discussed with and offered to HIV-1-infected pregnant women. Additionally, to prevent perinatal transmission, ZDV chemoprophylaxis should be incorporated into the antiretroviral regimen.read more
Citations
More filters
Journal Article
Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health-Care Settings
Bernard M. Branson,H. Hunter Handsfield,Margaret A. Lampe,Robert S. Janssen,Allan W. Taylor,Sheryl B. Lyss,Jill Clark +6 more
TL;DR: The objectives of these recommendations are to increase HIV screening of patients, including pregnant women, in health-care settings; foster earlier detection of HIV infection; identify and counsel persons with unrecognized HIV infection and link them to clinical and prevention services; and further reduce perinatal transmission of HIV in the United States.
Book
National Healthcare Disparities Report
TL;DR: The National Healthcare Disparities Report summarizes health care quality and access among various racial, ethnic, and income groups and other priority populations, such as residents of rural areas and people with disabilities.
Journal ArticleDOI
Antiretroviral Treatment for Adult HIV Infection in 2002: Updated Recommendations of the International AIDS Society-USA Panel
Patrick Yeni,Scott M. Hammer,Charles C. J. Carpenter,David A. Cooper,Margaret A. Fischl,Jose M. Gatell,Brian Gazzard,Martin S. Hirsch,Donna M. Jacobsen,David Katzenstein,Julio S. G. Montaner,Douglas D. Richman,Michael S. Saag,Mauro Schechter,Robert T. Schooley,Melanie A. Thompson,Stefano Vella,Paul A. Volberding +17 more
TL;DR: Because of increased awareness of the activity and toxicity of current drugs, the threshold for initiation of therapy has shifted to a later time in the course of HIV disease, however, the optimal time to initiate therapy remains imprecisely defined.
Journal ArticleDOI
Primary Care Guidelines for the Management of Persons Infected with Human Immunodeficiency Virus: 2009 Update by the HIV Medicine Association of the Infectious Diseases Society of America
Judith A. Aberg,Jonathan E. Kaplan,Howard Libman,Patricia Emmanuel,Jean Anderson,Valerie E. Stone,James M. Oleske,Judith S. Currier,Joel E. Gallant +8 more
TL;DR: These updated guidelines replace those published in 2004 and are intended for use by health care providers who care for HIV-infected patients or patients who may be at risk for acquiring HIV infection.
Journal ArticleDOI
Intrapartum and neonatal single-dose nevirapine compared with zidovudine for prevention of mother-to-child transmission of HIV-1 in Kampala, Uganda: 18-month follow-up of the HIVNET 012 randomised trial
J. Brooks Jackson,Philippa Musoke,Thomas Fleming,Thomas Fleming,Laura Guay,Danstan Bagenda,Melissa Allen,Clemensia Nakabiito,Joseph Sherman,Paul M Bakaki,Maxensia Owor,Constance Ducar,Martina Deseyve,Anthony Mwatha,Lynda Emel,Corey Duefield,Mark Mirochnick,Mary Glenn Fowler,Lynne M. Mofenson,Paolo G. Miotti,Maria Gigliotti,Dorothy Bray,Francis Mmiro +22 more
TL;DR: Intrapartum/ne ononatal nevirapine significantly lowered HIV-1 transmission risk in a breastfeeding population in Uganda compared with a short intrapartu/neonatal zidovudine regimen.
References
More filters
Journal ArticleDOI
Guidelines for the use of antiretroviral agents in HIV-infected adults and adolescents
Anthony S. Fauci,John G. Bartlett,Eric P. Goosby,M. D. Smith,H. J. Kaiser,S. W. Chang,James M. Anderson,R. Armstead,A. C. Baker,David A Barr,Samuel A. Bozzette,S. Cox,M. Delaney,Fred M. Gordin,W. Greaves,M. Harrington,J. J. Henning,Martin S. Hirsch,J. Jacobs,Richard Marlink,C. Maxwell,J. W. Mellors,D. B. Nash,S. Perryman,Robert T. Schooley,R. Sherer,Stephen A. Spector,G. Torres,Paul A. Volberding,B. A. Brady,E. M. Daniels,D. Feigal,Mark B. Feinberg,H. D. Gayle,T. R. Graydon,Jonathan E. Kaplan,Abe M. Macher,R. F. Martin,Henry Masur,Lynne M. Mofenson,J. Murray,J. O'Neill,L. C. Perez,R. Riseberg,S. Shekar,Sharilyn K. Stanley,J. Whitescarver +46 more
TL;DR: These Guidelines were developed by the Panel* on Clinical Practices for Treatment of HIV Infection convened by the Department of Health and Human Services and the Henry J. Kaiser Family Foundation.
Journal ArticleDOI
Reduction of maternal-infant transmission of human immunodeficiency virus type 1 with zidovudine treatment. Pediatric AIDS Clinical Trials Group Protocol 076 Study Group.
Edward M. Connor,Rhoda S. Sperling,Richard D. Gelber,Pavel Kiselev,Gwendolyn B. Scott,Mary Jo O'Sullivan,Russell Vandyke,Mohammed Bey,William T. Shearer,Robert L. Jacobson,Eleanor Jimenez,Edward O’neill,Brigitte Bazin,Jean François Delfraissy,Mary Culnane,Robert W. Coombs,Mary Elkins,Jack Moye,Pamela Stratton,James Balsley +19 more
TL;DR: In pregnant women with mildly symptomatic HIV disease and no prior treatment with antiretroviral drugs during the pregnancy, a regimen consisting of zidovudine given ante partum and intra partum to the mother and to the newborn for six weeks reduced the risk of maternal-infant HIV transmission by approximately two thirds.
Journal ArticleDOI
HIV-1 Dynamics in Vivo: Virion Clearance Rate, Infected Cell Life-Span, and Viral Generation Time
TL;DR: A new mathematical model was used to analyze a detailed set of human immunodeficiency virus-type 1 (HIV-1) viral load data collected from five infected individuals after the administration of a potent inhibitor of HIV-1 protease, providing not only a kinetic picture ofAIDS pathogenesis, but also theoretical principles to guide the development of treatment strategies.
Journal ArticleDOI
Adherence to protease inhibitor therapy and outcomes in patients with HIV infection.
David L. Paterson,Susan Swindells,J. Mohr,Michelle Brester,Emanuel N. Vergis,Cheryl Squier,Marilyn M. Wagener,Nina Singh +7 more
TL;DR: Given the critical importance of adherence to therapy to patient outcome, secondary prevention of HIV infection, and willingness of providers to prescribe therapy, this prospectively investigated the association between protease inhibitor adherence and patient outcome and factors related to adherence.
Journal ArticleDOI
A Controlled Trial of Two Nucleoside Analogues plus Indinavir in Persons with Human Immunodeficiency Virus Infection and CD4 Cell Counts of 200 per Cubic Millimeter or Less
Scott M. Hammer,Kathleen Squires,Michael Hughes,Michael Hughes,Janet M. Grimes,Lisa M. Demeter,Judith S. Currier,Joseph J. Eron,Judith Feinberg,Henry H. Balfour,Lawrence Deyton,Chodakewitz Jeffrey A,Margaret A. Fischl,John P. Phair,William Spreen,Louise Pedneault,Bach-Yen Nguyen,Jon C. Cook +17 more
TL;DR: In this article, the efficacy and safety of adding a protease inhibitor to two nucleoside analogues to treat human immunodeficiency virus type 1 (HIV-1) infection are not clear.
Related Papers (5)
Reduction of maternal-infant transmission of human immunodeficiency virus type 1 with zidovudine treatment. Pediatric AIDS Clinical Trials Group Protocol 076 Study Group.
Edward M. Connor,Rhoda S. Sperling,Richard D. Gelber,Pavel Kiselev,Gwendolyn B. Scott,Mary Jo O'Sullivan,Russell Vandyke,Mohammed Bey,William T. Shearer,Robert L. Jacobson,Eleanor Jimenez,Edward O’neill,Brigitte Bazin,Jean François Delfraissy,Mary Culnane,Robert W. Coombs,Mary Elkins,Jack Moye,Pamela Stratton,James Balsley +19 more
Reduction of maternal-infant transmission of human immunodeficiency virus 1 with zidovudine treatment
Edward M. Connor,Rhoda S. Sperling,Richard D. Gelber,Pavel Kiselev,Gwendolyn B. Scott,Mary J. O'Sullivan,Russell Vandyke,Mohammed Bey,William T. Shearer,R Jacobson,Eleanor Jimenez,Edward O’neill,Brigitte Bazin,Jean François Delfraissy,Mary Culnane,Robert W. Coombs,Mary Elkins,Jack Moye,Pamela Stratton,James Balsley +19 more
Guidelines for the use of antiretroviral agents in HIV-infected adults and adolescents
Anthony S. Fauci,John G. Bartlett,Eric P. Goosby,M. D. Smith,H. J. Kaiser,S. W. Chang,James M. Anderson,R. Armstead,A. C. Baker,David A Barr,Samuel A. Bozzette,S. Cox,M. Delaney,Fred M. Gordin,W. Greaves,M. Harrington,J. J. Henning,Martin S. Hirsch,J. Jacobs,Richard Marlink,C. Maxwell,J. W. Mellors,D. B. Nash,S. Perryman,Robert T. Schooley,R. Sherer,Stephen A. Spector,G. Torres,Paul A. Volberding,B. A. Brady,E. M. Daniels,D. Feigal,Mark B. Feinberg,H. D. Gayle,T. R. Graydon,Jonathan E. Kaplan,Abe M. Macher,R. F. Martin,Henry Masur,Lynne M. Mofenson,J. Murray,J. O'Neill,L. C. Perez,R. Riseberg,S. Shekar,Sharilyn K. Stanley,J. Whitescarver +46 more