title: Achieving rapid reduction of HIV-1 viral load in HIV-positive pregnant women close to term - an obstetric/medical emergency: a review of three cases.
abstract: Mother-to-child transmission (MTCT) of HIV infection is now uncommon in the UK and the management of HIV-positive pregnant women is usually relatively straightforward. However, HIV viral load suppression may be difficult to achieve peripartum for women who book very late in pregnancy and those with a poor adherence to antiretroviral therapy (ART). These pregnancies are at a higher risk of MTCT due to high viral load (VL). Therefore, the development of interventions to achieve a rapid reduction of HIV VL is essential. We describe three relevant cases that presented to our unit over a 12-month period and discuss the strategies employed to manage these challenging cases. All babies were born healthy and were HIV proviral DNA-negative at 12 weeks postpartum. No serious adverse events were reported for the mothers or their babies.
authors: Department of Obstetrics & Gynaecology, North Middlesex University Hospital NHS Trust, Edmonton, London N18 1QX, UK. wale.adeyemo@doctors.org.uk
authors: A
authors: A
authors: Adeyemo
authors: C
authors: C
authors: Wood
authors: A
authors: A
authors: Govind
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D023801:Directly Observed Therapy; D000077560:Enfuvirtide; D005260:Female; D015700:HIV Envelope Protein gp41 / Q000008:administration & dosage; D023581:HIV Fusion Inhibitors / Q000008:administration & dosage; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D015497:HIV-1 / Q000187:drug effects*; D006760:Hospitalization; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D010446:Peptide Fragments / Q000008:administration & dosage; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy* / Q000821:virology; D011256:Pregnancy Outcome; D011760:Pyrrolidinones / Q000008:administration & dosage; D000068898:Raltegravir Potassium; D016896:Treatment Outcome; D019562:Viral Load / Q000187:drug effects*
chemical_list: D044966:Anti-Retroviral Agents; D015700:HIV Envelope Protein gp41; D023581:HIV Fusion Inhibitors; D010446:Peptide Fragments; D011760:Pyrrolidinones; D000077560:Enfuvirtide; D000068898:Raltegravir Potassium
keywords: HIV in pregnancy; antiretroviral therapy; directly observed therapy; drug adherence; hospital admission; late presenter; maternal to child transmission; treatment; viral load; women