What is it?

HIV disease in humans can be caused by infection with either HIV-1 or HIV-2. HIV-1 is more prevalent of the two, has higher infectivity, virulence, and greater spread through heterosexual sex.

The study of HIV during pregnancy holds great significance because many women are first diagnosed with HIV during pregnancy. Similarly, it is equally important in cases where one or both partners are HIV positive and wish to conceive. During recent years, universal HIV prenatal testing, antiretroviral therapy (ART), scheduled cesarean delivery for HIV positive women with elevated viral loads, appropriate ART for infants and avoidance of breastfeeding have shown encouraging results.

HIV disease in humans can be caused by infection with either HIV-1 or HIV-2. HIV-1 is more prevalent of the two, has higher infectivity, virulence, and greater spread through heterosexual sex. The transmission rate of HIV from mother to child (vertical transmission) is 20% to 25% for HIV-1 versus about 5% for HIV-2. Vertical transmission of HIV is possible not only throughout pregnancy but also during childbirth and breastfeeding.

In the absence of any treatment, the risk of vertical transmission of HIV during pregnancy, delivery, or breastfeeding is as high as 25 to 30%. However, with rigorous testing, preconception counseling, good ART adherence, scheduled cesarean delivery, and infant prophylaxis, the rate of vertical transmission is as low as <1 to 2% in the developed countries.

In untreated HIV positive women, the risk of developing opportunistic infections increases with the fall in CD4 cell counts. Opportunistic infections like CMV and toxoplasmosis can cross the placenta and infect the fetus leading to congenital abnormalities. Also, untreated HIV infection has high chances of being passed on to the newborn in-utero, during delivery, or by breastfeeding.

ART regimens themselves are also associated with many complications.