All HIV-infected pregnant women

All HIV-infected pregnant women should be managed by an obstetrician with experience in dealing with HIV-infected women. Maximal obstetric precautions to minimize transmission of the HIV virus, such as avoiding scalp monitors and minimizing labor after rupture of the uterine membranes, should be observed. In addition, the potential use of an elective Caesarean section (C-section) should be discussed, particularly in those women without good viral control of their HIV infection where the risk of transmission may be increased. Breastfeeding should be avoided if alternative nutrition for the infant is available since HIV transmission can occur by this route। Updated guidelines for managing HIV-infected women are updated on a regular basis and can be

What about treating non-HIV-infected people exposed to the blood or genital secretions of an HIV-infected person?

Recently, a great deal of interest has focused on preventing transmission to uninfected people who are inadvertently exposed by the early administration of antiviral therapy. Because the risk of infection after most isolated exposures is relatively small and the number of patients needed for study would be great, formal studies are difficult to perform. Animal studies and some human experience, however, suggest that post-exposure treatment may be effective. In fact, the current recommendation is that health-care workers who experience a needle stick from an infected person take antiviral medication for four weeks in order to reduce the risk of infection. Guidelines now recommend similar preventive treatment for people with sexual exposures to HIV. Those individuals considering this type of preventative treatment, however, must be aware that post-exposure treatment cannot be relied upon to prevent HIV infection. Moreover, such treatment is not always available at the time most needed and is probably best restricted to unusual and unexpected exposures, such as a broken condom during intercourse. Although regimens with two or three drugs generally are recommended for those exposed in the health-care setting, the best therapy for sexual exposure still is unknown and ideally should be initiated within hours of exposure and certainly within the first several days.