[Consensus statement on monitoring of HIV: pregnancy, birth, and prevention of mother-to-child transmission].
OBJECTIVE
The main objective in the management of HIV-infected pregnant women is prevention of mother-to-child transmission; therefore, it is essential to provide universal antiretroviral treatment, regardless of CD4 count. All pregnant women must receive adequate information and undergo HIV serology testing at the first visit.


METHODS
We assembled a panel of experts appointed by the Secretariat of the National AIDS Plan (SPNS) and the other participating Scientific Societies, which included internal medicine physicians with expertise in the field of HIV infection, gynecologists, pediatricians and psychologists. Four panel members acted as coordinators. Scientific information was reviewed in publications and conference reports up to November 2012. In keeping with the criteria of the Infectious Diseases Society of America, 2levels of evidence were applied to support the proposed recommendations: the strength of the recommendation according to expert opinion (A, B, C), and the level of empirical evidence (I, II, III). This approach has already been used in previous documents from SPNS.


CONCLUSIONS
The aim of this paper was to review current scientific knowledge, and, accordingly, develop a set of recommendations regarding antiretroviral therapy (ART), regarding the health of the mother, and from the perspective of minimizing mother-to-child transmission (MTCT), also taking into account the rest of the health care of pregnant women with HIV infection. We also discuss and evaluate other strategies to reduce the MTCT (elective Cesarean, child's treatment…), and different aspects of the topic (ARV regimens, their toxicity, monitoring during pregnancy and postpartum, etc.).
Rosa
R
Polo Rodríguez
Eloy
E
Muñoz Galligo
José Antonio
JA
Iribarren
Pere
P
Domingo Pedrol
María
M
Leyes García
Vicente
V
Maiques Montesinos
Pilar
P
Miralles Martín
Antoni
A
Noguera Julian
Antonio
A
Ocampo Hernández
María Lourdes
ML
Péres Bares
Marta
M
López Rojano
Anna
A
Suy Franch
María Carmen
MC
Viñuela Beneitez
María Isabel
MI
González Tomé
D000465:Algorithms; D003267:Contraception / Q000592:standards; D036861:Delivery, Obstetric / Q000592:standards; D005260:Female; D015658:HIV Infections / Q000517:prevention & control* / Q000628:therapy / Q000635:transmission*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008991:Monitoring, Physiologic; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000517:prevention & control* / Q000628:therapy; D011295:Prenatal Care / Q000592:standards; D011795:Surveys and Questionnaires
Antiretroviral treatment in HIV pregnant women; Delivery; Embarazo; Mother-to-child transmission; Parto; Pregnancy; Transmisión materno-fetal; Tratamiento antirretroviral en la mujer embarazada con VIH