Recommendations for Use of Antiretroviral Drugs in Pregnant HIV-1-Infected Women for Maternal Health and Interventions to Reduce Perinatal HIV Transmission in the United States

These guidelines present health care providers with information for discussion with HIV-infected pregnant women to enable the patient/provider team to make informed decisions regarding the use of antiretroviral drugs during pregnancy and use of elective cesarean delivery to reduce perinatal HIV transmission. The recommendations are accompanied by discussion of various circumstances that commonly occur in clinical practice and the factors influencing treatment considerations. The current guidelines have been structured to reflect the management of an individual mother-child pair and are organized into a brief discussion of preconception care followed by principles for management of the mother and infant during the antepartum, intrapartum, and postpartum periods. Key issues and new information discussed in these guidelines are listed, including an outline of the guidelines development process, the rating scheme for recommendations, and lessons from clinical trials of antiretroviral intervention to reduce perinatal transmission of HIV. The appendix lists the financial disclosure for members of the panel and a supplement provides the safety and toxicity of individual antiretrovirals in pregnancy.