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Prophylaxis and treatment of HIV-1 infection in pregnancy: Swedish recommendations 2010.

Artikel i vetenskaplig tidskrift
Författare Lars Navér
Jan Albert
Erik Belfrage
Leo Flamholc
Magnus Gisslén
Katarina Gyllensten
Filip Josephson
Olof Karlström
Susanne Lindgren
Karin Pettersson
Veronica Svedhem
Anders Sönnerborg
Katarina Westling
Aylin Yilmaz
Publicerad i Scandinavian journal of infectious diseases
Volym 43
Nummer/häfte 6-7
Sidor 411-23
ISSN 1651-1980
Publiceringsår 2011
Publicerad vid Institutionen för biomedicin, avdelningen för infektionssjukdomar
Sidor 411-23
Språk en
Länkar dx.doi.org/10.3109/00365548.2011.56...
Ämneskategorier Mikrobiologi inom det medicinska området

Sammanfattning

Prophylaxis and treatment with antiretroviral drugs and the use of elective caesarean section have resulted in a very low mother-to-child transmission of human immunodeficiency virus (HIV) during recent years. The availability of new antiretroviral drugs, updated general treatment guidelines and increasing knowledge of the importance of drug resistance, have necessitated regular revisions of the "Prophylaxis and treatment of HIV-1 infection in pregnancy" recommendations. For these reasons, The Swedish Reference Group for Antiviral Therapy (RAV) updated the 2007 recommendations at an expert meeting that took place on 25 March 2010. The most important revisions from the previous recommendations are: (1) it is recommended that treatment during pregnancy starts at the latest at gestational week 14-18; (2) ongoing efficient treatment at confirmed pregnancy may, with a few exceptions, be continued; (3) lopinavir/r and atazanavir/r are equally recommended protease inhibitors; (4) if maternal HIV RNA is >50 copies/ml close to delivery, a planned caesarean section, intravenous zidovudine, oral nevirapine for the mother and post-exposure prophylaxis for the infant with 3 antiretroviral drugs are recommended; (5) for delivery at <34 gestational weeks, intravenous zidovudine and oral nevirapine for the mother and at 48-72 h for the infant is recommended, in addition to other prophylaxis; (6) intravenous zidovudine is not recommended when HIV RNA is <50 copies/ml and a caesarean section is performed; (7) it is recommended that prophylaxis for the infant is started within 4 h; (8) prophylactic zidovudine for the infant may be administered twice daily instead of 4 times a day, as was the case previously; and (9) the number of sampling occasions for the infant has been decreased.

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