Human immunodeficiency virus (HIV) infection in pregnancy: antiretroviral treatment (ART) and mode of delivery]

Antiretroviral therapy (ART) administered to pregnant women infected with HIV diminishes the rate of perinatal viral transmission. This is true for mono-, bi-, or tri-therapy (HAART), with the greatest effects being seen in the latter case. Nevertheless, when these therapies are employed, potential risks to the mother and fetus must be considered. These risks include hyperglycemia, lactic acidosis, mitochondrial toxicity, cutaneous rash, hepatitis, hypertension, and premature labor. Elective caesarean section reduces the perinatal transmission of HIV in patients with or without monotherapy, but has not shown a benefit in patients on tri-therapy (HAART). This article reviews the evidence for and against antiretroviral therapy and elective caesarean section in the setting of HIV in pregnancy and proposes treatment guidelines for these patients.