title: A systematic, multidisciplinary approach to address the reproductive needs of HIV-seropositive women.
abstract: Nearly 130,000 American women are human immunodeficiency virus (HIV) seropositive. The present study sought to establish a comprehensive programme to address their fertility needs in order to minimize infectious, medical and reproductive risks to prospective patients. Forty women, aged 27-42 years, were evaluated. HIV was diagnosed 7.2 +/- 0.7 years prior to their seeking care, and most women (n = 38) were on highly active antiretroviral therapy. Their prenatal CD4 counts were 712.2 +/- 56 cells/mm(3) (range 327-1881) and HIV-1 concentrations were undetectable in all cases prior to initiating treatment. HIV-seropositive women were statistically identical to their age-matched HIV-seronegative counterparts with respect to the IVF clinical outcome parameters measured. Throughout the pregnancies, maternal HIV-1 RNA concentrations remained undetectable and CD4 counts were stable. All infants, tested at birth and at 3 and 6 months of age, remained HIV negative. This is the first report of an institutional paradigm in the USA dedicated to evaluate and treat HIV-seropositive women. Using a multidisciplinary approach to care, HIV-seropositive women may be successfully managed in a programme of assisted reproduction.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, College of Physicians and Surgeons, Columbia University, 622 West 168th Street, PH 16-79, New York, NY 10032, USA. nd2058@columbia.edu
authors.forename: Nataki C
authors.initials: NC
authors.lastname: Douglas
authors.forename: Jeff G
authors.initials: JG
authors.lastname: Wang
authors.forename: Bo
authors.initials: B
authors.lastname: Yu
authors.forename: Sreedhar
authors.initials: S
authors.lastname: Gaddipati
authors.forename: Michael M
authors.initials: MM
authors.lastname: Guarnaccia
authors.forename: Mark V
authors.initials: MV
authors.lastname: Sauer
mesh_terms: D000328:Adult; D018791:CD4 Lymphocyte Count; D005260:Female; D006679:HIV Seropositivity; D015497:HIV-1 / Q000235:genetics; D006301:Health Services Needs and Demand; D006801:Humans; D012367:RNA, Viral / Q000097:blood; D012098:Reproduction; D027724:Reproductive Techniques, Assisted
chemical_list: D012367:RNA, Viral