Pregnancy receiving antiretroviral treatment of HIV1 infection in women
Posted by sldol on October 18, 2008 in Aids
Receiving antiretroviral treatment of HIV-1 infection in women, after the first three months of pregnancy should continue treatment. The first three months of pregnancy, ZDV should be antenatal antiretroviral therapy drugs. Receiving antiretroviral treatment of women on anti-retroviral treatment of the benefits and potential dangers, in the first three months of pregnancy should be consulted, should consider continuing treatment. If the first three months of pregnancy termination of treatment, all drugs should be suspended, at the same time to new drugs to avoid drug resistance. Whether prenatal how anti-retroviral treatment, birth and neonatal period should be recommended ZDV treatment. [1] [2] Next
Discussion:
Have received anti-retroviral treatment of HIV-1 infection in women, should continue treatment during pregnancy. Cessation of treatment can lead to increased viral load caused decline in immune status, disease progression, as well as women and the fetus adverse consequences.
Although ZDV for prenatal antiretroviral therapy drugs, but as the case may be, such as the emergence of ZDV-related toxicity or not. In addition, anti-retroviral treatment to women not using ZDV, but HIV-1RNA continuing low or no measurement, which adhere to the treatment benefit.
Prenatal antiretroviral treatment of mothers in childbirth sustained period of time as far as possible, to provide the maximum and minimum resistance to antiviral effect. If ZDV did not receive prenatal treatment, delivery period should remain static point ZDV. As a potential drug antagonism, the ZDV and d4T should not be used together. Oral d4T as prenatal treatment options, including the continued delivery of d4T or oral delivery of static points ZDV, stop oral d4T. In addition, infants should receive the standard six weeks of ZDV treatment.
Close to delivery, HIV-1RNA suppression of women, despite receiving a prenatal ZDV prevention and treatment, but is not yet clear whether the delivery period to another anti-retroviral drugs on the production of communication to provide protection. Prenatal did not receive anti-retroviral treatment of women’s studies found that two-dose nevirapine treatment (a single dose to the delivery of women; single dose to the infant 48 hours) and the production and post-natal period ZDV, significantly reduce perinatal transmission. In addition, prenatal antiretroviral treatment of women, the two-dose nevirapine does not reduce the spread. In the United States, has accepted the anti-retroviral treatment of women, maternity period not recommended plus nevirapine.
Accepted the anti-retroviral treatment of women, because it involves the potential deformity and early pregnancy is considered to suspend anti-retroviral treatment to three months after the first. When the medication during the 10 weeks of pregnancy, the data were not sufficient to support or refute anti-retroviral drugs malformation risk.
The first three months of pregnancy continued to anti-retroviral drug therapy by the clinical doctor and pregnant women decision. To discuss the pregnancy, including fetal age; women’s Clinical Immunology and viruses; anti-retroviral drugs on fetal known and unknown potential role. If the first three months of pregnancy to stop anti-retroviral treatment, should stop all drugs, while two in the first three months of pregnancy to begin treatment in order to avoid drug resistance. There is no data show that suspended the treatment of women or the fetus is harmful.
Health personnel may consider ZDV and other anti-retroviral drugs to the United neonatal medication, especially for ZDV resistant HIV-1 infection in women, with the progress of the disease ZDV, used alone or before the ZDV. The study of the effect is not clear, neonatal anti-retroviral drugs appropriate dose, short and long-term safety has not yet been established. Not entirely due to liver metabolism, kidney function immature, the neonatal period ZDV, 3TC and nevirapine to extend the half-life, neonatal special dose of medication needed adjustment. Neonatal period protease inhibitors are still studying the appropriate dose. On the newborn joint anti-retroviral drug benefits, the potential risk, appropriate doses of data, infected women should be consulted. Women should be told, it was not clear anti-retroviral drugs to reduce perinatal transmission of results.
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