Many professional organization recommend that all pregnant women be routinely counseled about HIV infection and be encouraged to be tested. What is the most impoant reason for early identification of HIV infection in pregnant women?
A randomized placebo controlled trial (ACTG 076) demonstrated that zidovudine (ZDV) given at the beginning of the second trimester, during labor and delivery, and to the newborn for 6 weeks significantly reduced the transmission of HIV to the newborn from 25.5 percent in the control group to 8.3 percent in the treatment group. Thus, ZDV can be highly effective for primary prevention in the newborn. Although a cesarean section has been shown to reduce veical transmission, it is less effective than ZDV and is not a routinely recommended procedure for HIV-infected pregnant women. HIV can be transmitted by breast feeding, and in some studies, the risk is increased by 14 percent. However, breast feeding has no impact on the highest risk of transmission, which occurs during gestation, labor, and delivery. Early identification of newborns at risk of HIV infection will guide the medical management and improve outcomes. It has no impact on the primary prevention of the infection to the newborn. Finally, all HIV-infected women should be made aware of the benefit of ZDV so they can make informed choices.
A cesarean section can be planned to reduced HIV transmission to the newborn.
Breast feeding can be discouraged to reduce transmission to the new born
Early identification of a new born at risk of HIV infection will improve survival
Zidovudine therapy can be offered to reduce the chance of transmission of HIV to the newborn