Human immunodeficiency virus (HIV) infection in pregnant women poses a multitude of dilemmas with regard to antiretroviral therapy (ART), potential teratogenicity of ART, mode of delivery and breast feeding concerns. We now have many newer drugs in HIV armamentarium with better safety and efficacy profiles, however, data of experience with some of the newer drugs in pregnancy is limited. The most important factor for prevention of mother to child transmission (MTCT) is early initiation of effective ART. Mother to child transmission can occur during antenatal period, during delivery and in postpartum period via breast feeding. Guidelines differ in resource rich countries and resource limited settings. In resource limited countries, breastfeeding is recommended keeping in view the potential benefits of breast feeding to the infant and financial and resource constraints. We need revised guidelines for management of HIV in pregnancy in resource limited settings and clinicians need to individualise delivery and breast feeding decisions based on patient’s viral load and socioeconomic factors even in resource limited settings.
Key words: HIV, pregnancy, antiretroviral therapy, mother to child transmission, breast feeding
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