Management of care of HIV-positive pregnant women in the period 1996–2014

Czech version

Authors: M. Mojhová ¹ ; I. Mikysková ¹; M. Halaška ¹; M. Staňková ²; H. Rozsypal ²; J. Šrámek ³; J. Záhumenský ⁴; M. Malý ⁵
Authors‘ workplace: Gynekologicko-porodnická klinika 1. LF UK a Nemocnice Na Bulovce, Praha, přednosta prof. MUDr. M. Halaška, DrSc. ¹; Klinika infekčních, parazitárních a tropických nemocí 1. LF UK, Praha, přednosta MUDr. H. Rozsypal, CSc. ²; Biofyzikální ústav LF Masarykovy univerzity, Brno, přednosta prof. RNDr. V. Mornstein, CSc. ³; Gynekologicko-porodnická klinika nemocnice, Trnava, přednosta doc. MUDr. J. Záhumenský, Ph. D. ⁴; Státní zdravotní ústav Praha, ředitel RNDr. V. Němeček, CSc. ⁵
Published in: Ceska Gynekol 2016; 81(3): 177-181

Overview

Objective:
The evaluation of multidisplinary care about HIV positive pregnant women in the Czech Republic.

Design:
Review.

Settings:
Gynekologicko-porodnická klinika 1. LF UK a Nemocnice na Bulovce, Praha.

Methods:
The vertical transmission of HIV infection from mother to fetus occurs most often during birth, still 1–2% of HIV-positive pregnant women will transfer the virus transplacenta. Due to careful screening for HIV during pregnancy, counselling, combination antiretroviral (cART) therapy, childbirth planning and its performance by C-section there appears a significant decrease of the virus transmission to the fetus, its occurrence is around 2%. If the HIV infection is detected in the context of screening for sexually transmitted infections (STIs), we begin with combined antiretroviral therapy (cART) depending on the level of viremia and CD4 as soon as possible. All HIV-positive pregnancies are tested for possible coinfection with hepatitis C. Since the first application of the antiretroviral treatment, the therapy is applies throughout the duration of the pregnancy. The labours of the HIV- positive women in the Czech Republic are scheduled. The primary choice is a caesarean section during the 38th week of pregnancy.

Conclusion:
From 1996–2014 the HIV positive status at 18 months of child age was confirmed in 4 cases in the Czech Republic. Three children were born to mothers whose HIV status was unknown at the time of the birth. Thanks to strict adherence to the interdisciplinary care, HIV positive woman have a chance to deliver a HIV-negative newborn and the risk of the transmission of the virus is significantly low.

Keywords:
vertical transmission, transplacental transmission, STI screening, cART, cesarean section, prophylactic cART therapy of newborn

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