HIV in pregnancy Flashcards
What is the most current way of diagnosing HIV?
HIV 1/HIV 2 immunoassay (antibody) + HIV P24 antigen detection (antigen)
If a patient is positive for the initial antibody/Antigen test for HIV what is the next step in diagnosis?
HIV 1/HIV 2 Antibody differentiation assay
What labs are monitored in pregnancy?
HIV RNA viral load
If properly treated during pregnancy the rate of vertical transmission is _____
< 2%
What is the general combination of medications used in pregnancy to treat HIV?
2 nucleoside reverse transcriptase inhibitors PLUS Integrase Strand transfer inhibitor, non nucleoside reverse transcriptase inhibitor, protease inhibitor+ pharmacokinetic enhancer
What is the Preferred 3 drug regimen in pregnancy?
Dolutegravir/abacavir/Lamivudine AFTER 14 wga
What medication is contraindicated in early pregnancy to treat HIV?
Dolutegravir prior to 14 wga, can cause NTD
When should you monitor HIV Viral load in pregnancy?
At initial visit, every 3 months in pregnancy
2-4 weeks after changing therapy
at 34 - 36 weeks gestational age to determine mode of delivery
How long does viral suppression take to achieve in most patients with HIV?
16 - 24 weeks
When should you monitor the CD4 count in pregnancy?
At initial visit and every 3 months
for what viral load does ZDV need to be administered?
For a Viral load > 1000 copies/ml
What is the mode of delivery for an HIV patient with a viral load > 1000 copies?
CS delivery at 38 wga
What is the delivery management of a patient with HIV who has an unknown Viral load?
ZSV + CS delivery at 38 wga
True or false: there is an uncertain benefit of CS delivery if a patient comes in in labor or following ROM?
True
True or false: AROM is not safe in labor even if the viral load is supressed?
False
