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

Naver, Lars; Albert, Jan; Belfrage, Erik; Flamholc, Leo LU ; Gisslen, Magnus; Gyllensten, Katarina; Josephson, Filip; Karlstrom, Olof; Lindgren, Susanne and Pettersson, Karin, et al. (2011) In Scandinavian Journal of Infectious Diseases 43(6-7). p.411-423
Abstract
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... (More)
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. (Less)
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organization
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Contribution to journal
publication status
published
subject
keywords
HIV, pregnancy, mother-to-child transmission, prophylaxis, infant
in
Scandinavian Journal of Infectious Diseases
volume
43
issue
6-7
pages
411 - 423
publisher
Informa Healthcare
external identifiers
  • wos:000291662600002
  • scopus:79959252312
ISSN
1651-1980
DOI
10.3109/00365548.2011.567392
language
English
LU publication?
yes
id
acfad501-6087-4c23-9732-ef4dadb8b92b (old id 2049416)
date added to LUP
2011-08-02 09:01:36
date last changed
2017-02-26 03:43:56
@article{acfad501-6087-4c23-9732-ef4dadb8b92b,
  abstract     = {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 &gt;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 &lt;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 &lt;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.},
  author       = {Naver, Lars and Albert, Jan and Belfrage, Erik and Flamholc, Leo and Gisslen, Magnus and Gyllensten, Katarina and Josephson, Filip and Karlstrom, Olof and Lindgren, Susanne and Pettersson, Karin and Svedhem, Veronica and Sonnerborg, Anders and Westling, Katarina and Yilmaz, Aylin},
  issn         = {1651-1980},
  keyword      = {HIV,pregnancy,mother-to-child transmission,prophylaxis,infant},
  language     = {eng},
  number       = {6-7},
  pages        = {411--423},
  publisher    = {Informa Healthcare},
  series       = {Scandinavian Journal of Infectious Diseases},
  title        = {Prophylaxis and treatment of HIV-1 infection in pregnancy: Swedish Recommendations 2010},
  url          = {http://dx.doi.org/10.3109/00365548.2011.567392},
  volume       = {43},
  year         = {2011},
}