HIV infection in pregnancy


Key articles

Panel on Treatment of HIV During Pregnancy and Prevention of Perinatal Transmission. Recommendations for the use of antiretroviral drugs during pregnancy and interventions to reduce perinatal HIV transmission in the United States. Mar 2022 [internet publication].Full text

Reference articles

1. Van de Perre P, Simonon A, Msellati P, et al. Postnatal transmission of human immunodeficiency virus type 1 from mother to infant. A prospective cohort study in Kigali, Rwanda. N Engl J Med. 1991 Aug 29;325(9):593-8. Abstract

2. UNAIDS. Women, adolescent girls and the HIV response. Mar 2020 [internet publication].Full text

3. UNAIDS. UNAIDS data 2021. Nov 2021 [internet publication].Full text

4. Centers for Disease Control and Prevention. HIV and women: HIV diagnoses. Mar 2022 [internet publication].Full text

5. World Health Organization. The Global Health Observatory. Data on the HIV/AIDS response [internet publication].Full text

6. UN Joint Programme on HIV/AIDS. WHO validates elimination of mother-to-child transmission of HIV and syphilis in Cuba. Jun 2015 [internet publication].Full text

7. Panel on Treatment of HIV During Pregnancy and Prevention of Perinatal Transmission. Recommendations for the use of antiretroviral drugs during pregnancy and interventions to reduce perinatal HIV transmission in the United States. Mar 2022 [internet publication].Full text

8. World Health Organization. Global guidance on criteria and processes for validation: elimination of mother-to-child transmission of HIV, syphilis and hepatitis B virus. Nov 2021 [internet publication].Full text

9. Centers for Disease Control and Prevention. HIV and pregnant women, infants, and children. Mar 2022 [internet publication].Full text

10. Louis J, Landon MB, Gersnoviez RJ, et al. Perioperative morbidity and mortality among human immunodeficiency virus infected women undergoing cesarean delivery. Obstet Gynecol. 2007 Aug;110(2 Pt 1):385-90. Abstract

11. Haeri S, Shauer M, Dale M, et al. Obstetric and newborn infant outcomes in human immunodeficiency virus-infected women who receive highly active antiretroviral therapy. Am J Obstet Gynecol. 2009 Sep;201(3):315.e1-5. Abstract

12. Suy A, Martínez E, Coll O, et al. Increased risk of pre-eclampsia and fetal death in HIV-infected pregnant women receiving highly active antiretroviral therapy. AIDS. 2006 Jan 2;20(1):59-66. Abstract

13. Parikh L, Timofeev J, Singh J, et al. Racial disparities in maternal and neonatal outcomes in HIV-1 positive mothers. Am J Perinatol. 2014 Jun;31(6):513-20. Abstract

14. Kourtis AP, Ellington S, Pazol K, et al. Complications of cesarean deliveries among HIV-infected women in the United States. AIDS. 2014 Nov 13;28(17):2609-18.Full text  Abstract

15. Nyamweya S, Hegedus A, Jaye A, et al. Comparing HIV-1 and HIV-2 infection: lessons for viral immunopathogenesis. Rev Med Virol. 2013 Jul;23(4):221-40. Abstract

16. Cao Y, Krogstad P, Korber BT, et al. Maternal HIV-1 viral load and vertical transmission of infection: the Ariel Project for the prevention of HIV transmission from mother to infant. Nat Med. 1997 May;3(5):549-52. Abstract

17. Lifson JD, Reyes GR, McGrath MS, et al. AIDS retrovirus induced cytopathology: giant cell formation and involvement of CD4 antigen. Science. 1986 May 30;232(4754):1123-7. Abstract

18. Ameisen JC, Capron A. Cell dysfunction and depletion in AIDS: the programmed cell death hypothesis. Immunol Today. 1991 Apr;12(4):102-5. Abstract

19. Ameisen JC, Estaquier J, Idziorek T. From AIDS to parasite infection: pathogen-mediated subversion of programmed cell death as a mechanism for immune dysregulation. Immunol Rev. 1994 Dec;142:9-51. Abstract

20. Mofenson LM. Pregnancy and perinatal transmission of HIV infection. In: Holmes KK, Sparling PF, Stamm WE, et al, eds. Sexually transmitted diseases. 4th ed. New York, NY: McGraw-Hill; 2008:1659-93.

21. Cooper ER, Charurat M, Mofenson L, et al; Women and Infants' Transmission Study Group. Combination antiretroviral strategies for the treatment of pregnant HIV-1-infected women and prevention of perinatal HIV-1 transmission. J Acquir Immune Defic Syndr. 2002 Apr 15;29(5):484-94. Abstract

22. Magder LS, Mofenson L, Paul ME, et al. Risk factors for in utero and intrapartum transmission of HIV. J Acquir Immune Defic Syndr. 2005 Jan 1;38(1):87-95. Abstract

23. De Cock KM, Fowler MG, Mercier E, et al. Prevention of mother-to-child HIV transmission in resource-poor countries: translating research into policy and practice. JAMA. 2000 Mar 1;283(9):1175-82. Abstract

24. Wabwire-Mangen F, Gray RH, Mmiro FA, et al. Placental membrane inflammation and risks of maternal-to-child transmission of HIV-1 in Uganda. J Acquir Immune Defic Syndr. 1999 Dec 1;22(4):379-85. Abstract

25. Van Dyke RB, Korber BT, Popek E, et al. The Ariel Project: a prospective cohort study of maternal-child transmission of human immunodeficiency virus type 1 in the era of maternal antiretroviral therapy. J Infect Dis. 1999 Feb;179(2):319-28. [Erratum in: J Infect Dis. 1999 Mar;179(3):754.] Abstract

26. Farquhar C, Rowland-Jones S, Mbori-Ngacha D, et al. Human leukocyte antigen (HLA) B*18 and protection against mother-to-child HIV type 1 transmission. AIDS Res Hum Retroviruses. 2004 Jul;20(7):692-7. Abstract

27. Kostrikis LG, Neumann AU, Thomson B, et al. A polymorphism in the regulatory region of the CC-chemokine receptor 5 gene influences perinatal transmission of human immunodeficiency virus type 1 to African-American infants. J Virol. 1999 Dec;73(12):10264-71.Full text  Abstract

28. LaRussa P, Magder LS, Pitt J, et al; Women and Infants Transmission Study. Association of HIV-1 viral phenotype in the MT-2 assay with perinatal HIV transmission. J Acquir Immune Defic Syndr. 2002 May 1;30(1):88-94. Abstract

29. Renjifo B, Gilbert P, Chaplin B, et al; Tanzanian Vitamin and HIV Study Group. Preferential in-utero transmission of HIV-1 subtype C as compared to HIV-1 subtype A or D. AIDS. 2004 Aug 20;18(12):1629-36. Abstract

30. Winchester R, Pitt J, Charurat M, et al. Mother-to-child transmission of HIV-1: strong association with certain maternal HLA-B alleles independent of viral load implicates innate immune mechanisms. J Acquir Immune Defic Syndr. 2004 Jun 1;36(2):659-70. Abstract

31. Yang C, Li M, Newman RD, et al. Genetic diversity of HIV-1 in western Kenya: subtype-specific differences in mother-to-child transmission. AIDS. 2003 Jul 25;17(11):1667-74. Abstract

32. Rouzioux C, Costagliola D, Burgard M, et al. Estimated timing of mother-to-child human immunodeficiency virus type 1 (HIV-1) transmission by use of a Markov model. The HIV Infection in Newborns French Collaborative Study Group. Am J Epidemiol. 1995 Dec 15;142(12):1330-7. Abstract

33. Kourtis AP, Bulterys M, Nesheim SR, et al. Understanding the timing of HIV transmission from mother to infant. JAMA. 2001 Feb 14;285(6):709-12. Abstract

34. Tersmette M, Gruters RA, de Wolf F, et al. Evidence for a role of virulent human immunodeficiency virus (HIV) variants in the pathogenesis of acquired immunodeficiency syndrome: studies on sequential HIV isolates. J Virol. 1989 May;63(5):2118-25.Full text  Abstract

35. Schwartz S, Felber BK, Fenyo EM, et al. Rapidly and slowly replicating human immunodeficiency virus type 1 isolates can be distinguished according to target-cell tropism in T-cell and monocyte cell lines. Proc Natl Acad Sci U S A. 1989 Sep;86(18):7200-3.Full text  Abstract

36. Fenyo EM, Albert J, Asjo B. Replicative capacity, cytopathic effect and cell tropism of HIV. AIDS. 1989;3 (suppl 1):S5-12. Abstract

37. Shapiro RL, Hughes MD, Ogwu A, et al. Antiretroviral regimens in pregnancy and breast-feeding in Botswana. N Engl J Med. 2010 Jun 17;362(24):2282-94. Abstract

38. Fowler MG, Newell ML. Breast-feeding and HIV-1 transmission in resource-limited settings. J Acquir Immune Defic Syndr. 2002 Jun 1;30(2):230-9. Abstract

39. Leroy V, Karon JM, Alioum A, et al; West Africa PMTCT Study Group. Twenty-four month efficacy of a maternal short-course zidovudine regimen to prevent mother-to-child transmission of HIV-1 in West Africa. AIDS. 2002 Mar 8;16(4):631-41. Abstract

40. Wiktor SZ, Ekpini E, Karon JM, et al. Short-course oral zidovudine for prevention of mother-to-child transmission of HIV-1 in Abidjan, Côte d'Ivoire: a randomised trial. Lancet. 1999 Mar 6;353(9155):781-5. Abstract

41. John-Stewart G, Mbori-Ngacha D, Ekpini R, et al; Ghent IAS Working Group on HIV in Women and Children. Breast-feeding and transmission of HIV-1. J Acquir Immune Defic Syndr. 2004 Feb 1;35(2):196-202. Abstract

42. World Health Organization. Guideline: updates on HIV and infant feeding. 2016 [internet publication].Full text

43. Baggaley RF, Boily MC, White RG, et al. Risk of HIV-1 transmission for parenteral exposure and blood transfusion: a systematic review and meta-analysis. AIDS. 2006 Apr 4;20(6):805-12.Full text  Abstract

44. Centers for Disease Control and Prevention. HIV infection and HIV-associated behaviors among injecting drug users - 20 cities, United States, 2009. MMWR Morb Mortal Wkly Rep. 2012 Mar 2;61(8):133-8.Full text  Abstract

45. World Health Organization. HIV/AIDS: people who inject drugs [internet publication].Full text

46. Boily MC, Baggaley RF, Wang L, et al. Heterosexual risk of HIV-1 infection per sexual act: systematic review and meta-analysis of observational studies. Lancet Infect Dis. 2009 Feb;9(2):118-29.Full text  Abstract

47. Jin F, Jansson J, Law M, et al. Per-contact probability of HIV transmission in homosexual men in Sydney in the era of HAART. AIDS. 2010 Mar 27;24(6):907-13.Full text  Abstract

48. Bell DM. Occupational risk of human immunodeficiency virus infection in health care workers: an overview. Am J Med. 1997 May 19;102(5B):9-15. Abstract

49. Sexton J, Garnett G, Røttingen JA. Metaanalysis and metaregression in interpreting study variability in the impact of sexually transmitted diseases on susceptibility to HIV infection. Sex Transm Dis. 2005 Jun;32(6):351-7. Abstract

50. Braunstein SL, van de Wijgert JH, Nash D. HIV incidence in sub-Saharan Africa: a review of available data with implications for surveillance and prevention planning. AIDS Rev. 2009 Jul-Sep;11(3):140-56. Abstract

51. van de Wijgert JH, Morrison CS, Brown J, et al. Disentangling contributions of reproductive tract infections to HIV acquisition in African Women. Sex Transm Dis. 2009 Jun;36(6):357-64. Abstract

52. Ward H, Rönn M. Contribution of sexually transmitted infections to the sexual transmission of HIV. Curr Opin HIV AIDS. 2010 Jul;5(4):305-10.Full text  Abstract

53. Devries KM, Kishor S, Johnson H, et al. Intimate partner violence during pregnancy: analysis of prevalence data from 19 countries. Reprod Health Matters. 2010 Nov;18(36):158-70. Abstract

54. Cavanaugh CE, Hansen NB, Sullivan TP. HIV sexual risk behavior among low-income women experiencing intimate partner violence: the role of posttraumatic stress disorder. AIDS Behav. 2010 Apr;14(2):318-27.Full text  Abstract

55. Machtinger EL, Wilson TC, Haberer JE, et al. Psychological trauma and PTSD in HIV-positive women: a meta-analysis. AIDS Behav. 2012 Nov;16(8):2091-100. Abstract

56. Varghese B, Maher JE, Peterman TA, et al. Reducing the risk of sexual HIV transmission: quantifying the per-act risk for HIV on the basis of choice of partner, sex act, and condom use. Sex Transm Dis. 2002 Jan;29(1):38-43. Abstract

57. Baggaley RF, White RG, Boily MC. Systematic review of orogenital HIV-1 transmission probabilities. Int J Epidemiol. 2008 Dec;37(6):1255-65.Full text  Abstract

58. Bassett MT, McFarland WC, Ray S, et al. Risk factors for HIV infection at enrollment in an urban male factory cohort in Harare, Zimbabwe. J Acquir Immune Defic Syndr Hum Retrovirol. 1996 Nov 1;13(3):287-93. Abstract

59. Chattopadhya D, Riley LW, Kumari S. Behavioural risk factors for acquisition of HIV infection and knowledge about AIDS among male professional blood donors in Delhi. Bull World Health Organ. 1991;69(3):319-23. Abstract

60. US Department of Health and Human Services, Health Resources and Services Administration. A guide to the clinical care of women with HIV. 2013 [internet publication].Full text

61. Thomson KA, Hughes J, Baeten JM, et al. Increased risk of HIV acquisition among women throughout pregnancy and during the postpartum period: a prospective per-coital-act analysis among women with HIV-infected partners. J Infect Dis. 2018 Jun 5;218(1):16-25.Full text  Abstract

62. Branson BM, Handsfield HH, Lampe MA, et al. Revised recommendations for HIV testing of adults, adolescents, and pregnant women in health-care settings. MMWR Morb Mortal Wkly Rep. 2006 Sep 22;55(RR-14):1-17.Full text  Abstract

63. World Health Organization. WHO continues to support its conditional recommendation for the dapivirine vaginal ring as an additional prevention option for women at substantial risk of HIV. Dec 2021 [internet publication].Full text

64. Cutler B, Justman J. Vaginal microbicides and the prevention of HIV transmission. Lancet Infect Dis. 2008 Nov;8(11):685-97.Full text  Abstract

65. Wiysonge CS, Shey MS, Shang J, et al. Vaginal microbicides for preventing mother-to-child transmission of HIV infection: no evidence of an effect or evidence of no effect? S Afr Med J. 2007 Jul;97(7):530-3. Abstract

66. Abdool Karim Q, Abdool Karim SS, Frohlich JA, et al. Effectiveness and safety of tenofovir gel, an antiretroviral microbicide, for the prevention of HIV infection in women. Science. 2010 Sep 3;329(5996):1168-74.Full text  Abstract

67. Holmes KK, Levine R, Weaver M. Effectiveness of condoms in preventing sexually transmitted infections. Bull World Health Organ. 2004 Jun;82(6):454-61.Full text  Abstract

68. French PP, Latka M, Gollub EL, et al. Use-effectiveness of the female versus the male condom in preventing sexually transmitted diseases in women. Sex Transm Dis. 2003 May;30(5):433-9. Abstract

69. Centers for Disease Control and Prevention (CDC); Association of Public Health Laboratories. Laboratory testing for the diagnosis of HIV infection: updated recommendations. Jun 2014 [internet publication].Full text

70. Pilcher CD, Fiscus SA, Nguyen TQ, et al. Detection of acute infections during HIV testing in North Carolina. N Engl J Med. 2005 May 5;352(18):1873-83.Full text  Abstract

71. Connor EM, Sperling RS, Gelber R, et al. Reduction of maternal-infant transmission of human immunodeficiency virus type 1 with zidovudine treatment. N Engl J Med. 1994 Nov 3;331(18):1173-80.Full text  Abstract

72. Kovacs A, Xu J, Rasheed S, et al. Comparison of a rapid nonisotopic polymerase chain reaction assay with four commonly used methods for the early diagnosis of human immunodeficiency virus type 1 infection in neonates and children. Pediatr Infect Dis J. 1995 Nov;14(11):948-54. Abstract

73. Kaplan EH, Heimer R. HIV incidence among New Haven needle exchange participants: updated estimates from syringe tracking and testing data. J Acquir Immune Def Syndr Hum Retrovirol. 1995 Oct 1;10(2):175-6. Abstract

74. Chadwick EG, Ezeanolue EE, and Committee on Pediatric AIDS. Evaluation and Management of the Infant Exposed to HIV in the United States. Pediatrics. 2020 Nov;146(5):e2020029058.Full text  Abstract

75. Townsend CL, Cortina-Borja M, Peckham CS, et al. Antiretroviral therapy and premature delivery in diagnosed HIV-infected women in the United Kingdom and Ireland. AIDS. 2007 May 11;21(8):1019-26. Abstract

76. Schulte J, Dominguez K, Sukalac T, et al. Declines in low birth weight and preterm birth among infants who were born to HIV-infected women during an era of increased use of maternal antiretroviral drugs: pediatric spectrum of HIV disease, 1989-2004. Pediatrics. 2007 Apr;119(4):e900-6. Abstract

77. Ravizza M, Martinelli P, Bucceri A, et al. Treatment with protease inhibitors and coinfection with hepatitis C virus are independent predictors of preterm delivery in HIV-infected pregnant women. J Infect Dis. 2007 Mar 15;195(6):913-4.Full text  Abstract

78. Grosch-Woerner I, Puch K, Maier RF, et al. Increased rate of prematurity associated with antenatal antiretroviral therapy in a German/Austrian cohort of HIV-1-infected women. HIV Med. 2008 Jan;9(1):6-13.Full text  Abstract

79. Kourtis AP, Schmid CH, Jamieson DJ, et al. Use of antiretroviral therapy in pregnant HIV-infected women and the risk of premature delivery: a meta-analysis. AIDS.2007 Mar 12;21(5):607-15. Abstract

80. European Collaborative Study, Swiss Mother and Child HIV Cohort Study. Combination antiretroviral therapy and duration of pregnancy. AIDS. 2000 Dec 22;14(18):2913-20. Abstract

81. Lorenzi P, Spicher VM, Laubreau B, et al. Antiretroviral therapies in pregnancy: maternal, fetal, and neonatal effects. Swiss HIV Cohort Study, the Swiss Collaborative HIV and Pregnancy Study, the Swiss Neonatal HIV Study. AIDS. 1998 Dec 24;12(18):F241-7. Abstract

82. Szyld EG, Warley EM, Freimanis L, et al. Maternal antiretroviral drugs during pregnancy and infant low birth weight and preterm birth. AIDS. 2006 Nov 28;20(18):2345-53. Abstract

83. World Health Organization. Update of recommendations on first- and second-line antiretroviral regimens. Jul 2019 [internet publication].Full text

84. ACOG Committee on Obstetric Practice. ACOG committee opinion: scheduled cesarean delivery and the prevention of vertical transmission of HIV infection. Number 234, May 2000 (replaces number 219, August 1999). Int J Gynaecol Obstet. 2001 Jun;73(3):279-81. Abstract

85. Flynn PM, Taha TE, Cababasay M, et al. Prevention of HIV-1 transmission through breastfeeding: efficacy and safety of maternal antiretroviral therapy versus infant nevirapine prophylaxis for duration of breastfeeding in HIV-1-infected women with high CD4 cell count (IMPAACT PROMISE): a randomized, open-label, clinical trial. J Acquir Immune Defic Syndr. 2018 Apr 1;77(4):383-92.Full text  Abstract

86. Luoga E, Vanobberghen F, Bircher R, et al. Brief report: no HIV transmission from virally suppressed mothers during breastfeeding in rural Tanzania. J Acquir Immune Defic Syndr. 2018 Sep 1;79(1):e17-e20.Full text  Abstract

87. Food and Drug Administration. FDA Drug Safety Communication: FDA to evaluate potential risk of neural tube birth defects with HIV medicine dolutegravir (Juluca, Tivicay, Triumeq). May 2018 [internet publication].Full text

88. European Medicines Agency. New study suggests risk of birth defects in babies born to women on HIV medicine dolutegravir. May 2018 [internet publication].Full text

89. Zash R, Holmes L, Diseko M, et al. Neural-tube defects and antiretroviral treatment regimens in Botswana. N Engl J Med. 2019 Aug 29;381(9):827-40.Full text  Abstract

90. Raesima MM, Ogbuabo CM, Thomas V, et al. Dolutegravir use at conception - additional surveillance data from Botswana. N Engl J Med. 2019 Aug 29;381(9):885-7.Full text  Abstract

91. Williams PL, Crain MJ, Yildirim C, et al. Congenital anomalies and in utero antiretroviral exposure in human immunodeficiency virus-exposed uninfected infants. JAMA Pediatr. 2015 Jan;169(1):48-55.Full text  Abstract

92. Ford N, Calmy A, Mofenson L. Safety of efavirenz in the first trimester of pregnancy: an updated systematic review and meta-analysis. AIDS. 2011 Nov 28;25(18):2301-4. Abstract

93. Williams PL, Yildirim C, Chadwick EG, et al. Association of maternal antiretroviral use with microcephaly in children who are HIV-exposed but uninfected (SMARTT): a prospective cohort study. Lancet HIV. 2020 Jan;7(1):e49-e58.Full text  Abstract

94. Brocklehurst P, French R. The association between maternal HIV infection and perinatal outcome: a systematic review of the literature and meta-analysis. Br J Obstet Gynaecol. 1998 Aug;105(8):836-48. Abstract

95. Leroy V, Ladner J, Nyiraziraje M, et al. Effect of HIV-1 infection on pregnancy outcome in women in Kigali, Rwanda 1992-1994. Pregnancy and HIV Study Group. AIDS. 1998 Apr 16;12(6):643-50. Abstract

96. Martin R, Boyer P, Hammill H, et al. Incidence of premature birth and neonatal respiratory disease in infants of HIV-positive mothers. The Pediatric Pulmonary and Cardiovascular Complications of Vertically Transmitted Human Immunodeficiency Virus Infection Study Group. J Pediatr. 1997 Dec;131(6):851-6. Abstract

97. Puchalski Ritchie LM, van Lettow M, Pham B, et al. What interventions are effective in improving uptake and retention of HIV-positive pregnant and breastfeeding women and their infants in prevention of mother to child transmission care programmes in low-income and middle-income countries? A systematic review and meta-analysis. BMJ Open. 2019 Jul 29;9(7):e024907.Full text  Abstract

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