Aids και κύηση

Postgraduate Thesis uoadl:1314669 321 Read counter

Unit:
Κατεύθυνση Παθολογία της Κύησης
Library of the School of Health Sciences
Deposit date:
2014-11-24
Year:
2014
Author:
Αραμπατζή Ελένη
Supervisors info:
Kαθηγητής Δ. Κασσάνος
Original Title:
Aids και κύηση
Languages:
Greek
Summary:
In recent years more and more children are born in the world from HIV positive
mothers. According to WHO, approximately 3,200 000 children around the world
are living with HIV. Without specific therapeutic intervention to reduce the
risk, 15-45% of all infected pregnant women will transmit the infection to
their children, of which 5-10% will be infected transplacentally, 10-20% after
perinatal exposure and 5-20% through the breastfeeding. Breastfeeding accounts
for 50% of HIV infections in newborns living in third world countries. The
application of prevention policies in recent years has lessened the vertical
transmission at rates < 2%. The complex mechanisms and factors that determine
whether an infant will acquire the infection have not been fully clarified.
Apart from the viral load, there are several factors associated with increased
risk of transmission in utero and during childbirth. Advanced disease, various
obstetrical manipulations, the simultaneous presence of other STDs and
co-infection with hepatitis C or active tuberculosis, increase the risk of
vertical transmission. In this thesis a review of contemporary literature was
presented, aimed at description of risk factors and the pathophysiological
processes that define the perinatal transmission of HIV infection. At the same
time a summary of the history of the disease, the structure of HIV, the
clinical staging of infection and the immunobiological outcomes for the human
body were included. In the special part of this study effort was paid to
explain the effect of both the disease as well as of the antiretroviral therapy
in the evolution and outcome of a pregnancy. The relationship of the infection
and breastfeeding was thoroughly presented. Recent epidemiological data of
the disease and newly created guidelines for diagnosis and treatment of the
disease in the general population but with a particular focus on pregnant women
and their infants were also incorporated. . When the mother's health requires
the granting of ART, this must be done directly even in the first trimester of
pregnancy.
For women who were already receiving effective HAART at conception, the
continuation of the same treatmen is recommendedt throughout the pregnancy .
During pregnancy, the pregnant woman should be closely monitored as regards HIV
infection (viral load, CD4 levels, endurance), as well as for potential
toxicity from antiretroviral medications.Childbirth with cesarean section is
scheduled for women with detectable viral load, while for women with a load <
50 copies/ml the risk of vertical transmission in normal childbirth does not
exceeds the risks of complications from caesarean section.The intravenous ZDV
during labor and delivery reduces even more the possibility of vertical
transmission.
In all cases the handling of pregnant HIV positive woman must include outside
of the specialized medical care from all disciplines involved, the appropriate
support both in psychological and social level, before conception,throughout
pregnancy and there after.
Keywords:
AIDS, HIV, Perinatal transmission, Vertical transmission, Breastfeeding
Index:
No
Number of index pages:
0
Contains images:
Yes
Number of references:
192
Number of pages:
181
File:
File access is restricted.

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