Natural pregnancies in HIV-serodiscordant couples receiving successful antiretroviral therapy.
Increasing numbers of HIV-serodiscordant heterosexual couples are concerned about the chances for pregnancy. We reviewed all natural pregnancies attained by HIV-serodiscordant couples seen in 3 clinics in Spain, in which the infected partner had undetectable plasma viremia while receiving highly active antiretroviral therapy (HAART). In the case of HIV-infected mothers, only those with undetectable viremia during pregnancy and at delivery were chosen. A total of 62 HIV-serodiscordant couples, 22 HIV-infected women (mean CD4 count of 522 cells/microL, 55% hepatitis C virus [HCV]-seropositive) and 40 HIV-infected men (mean CD4 count of 629 cells/microL, 75% HCV-seropositive), were recorded. Overall, 76 natural pregnancies occurred, and 68 children were born. There were 9 fetal deaths, 1 twin pregnancy, 6 couples with 2 consecutive babies, and 4 couples with 3 consecutive newborns. There were no cases of HIV seroconversion in uninfected sexual partners. One case of vertical HIV transmission occurred, however. Serodiscordant couples attaining natural pregnancy are exposed to a negligible risk of sexual transmission of HIV when the infected partner presents with complete suppression of plasma viremia while receiving HAART.
Barreiro
Pablo
P
Department of Infectious Diseases, Hospital Carlos III, Madrid, Spain. pbarreiro@v4066.drago.net
del Romero
Jorge
J
Leal
Manuel
M
Hernando
Victoria
V
Asencio
Román
R
de Mendoza
Carmen
C
Labarga
Pablo
P
Núñez
Marina
M
Ramos
José Tomás
JT
González-Lahoz
Juan
J
Soriano
Vincent
V
D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects* / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000517:prevention & control / Q000523:psychology* / Q000635:transmission*; D006679:HIV Seropositivity; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D018445:Infectious Disease Transmission, Vertical; D008297:Male; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D012189:Retrospective Studies
D019380:Anti-HIV Agents