HIV in pregnancy

Definition

• HIV in pregnancy denotes infection of a pregnant woman with human immunodeficiency virus, a lymphotropic lentivirus of the retrovirus family.

Occurrence & epidemiology

Epidemiology

• Many women are first diagnosed with HIV infection during pregnancy.

Aetiopathogenesis

Aetiology and pathogenesis

• Infectiousness correlates with the level of viral load in blood and body secretions; when the viral load is below the limit of detection, it is practically abolished.

Clinical features

Clinical features and complications

• With advanced immunodeficiency, life-threatening opportunistic infections occur, the most important being Pneumocystis jirovecii pneumonia.
• Infants and young children progress faster; developmental disorders and severe bacterial infections predominate.

Diagnosis

• Diagnosis follows a two-step approach with screening and confirmatory test; fourth-generation screening assays detect antibodies and antigen.
• A reactive screening test is confirmed by immunoblot or by detection of viral nucleic acids.
• CD4 helper cell count and viral load are important prognostic markers.
• In the newborn, antibody testing is not informative because of maternal antibodies; diagnosis relies on nucleic acid testing.

Keep learning in the app

Further reading (selection)

1. Robert Koch Institute, RKI-Ratgeber (German): HIV-Infektion/AIDS
2. StatPearls: HIV in Pregnancy (NCBI Bookshelf)

Cross-references