Recommendations for the Use of Antiretroviral Drugs in Pregnant Women with HIV Infection and Interventions to Reduce Perinatal HIV Transmission in the United States

The information in the brief version is excerpted directly from the full-text guidelines. The brief version is a compilation of the tables and boxed recommendations.

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HIV-2 Infection and Pregnancy

Last Updated: December 7, 2018; Last Reviewed: December 7, 2018

Panel's Recommendations Regarding HIV-2 Infection and Pregnancy
Panel's Recommendations
  • HIV-2 infection should be considered in pregnant women who are from—or who have partners from—countries in which the disease is endemic and who have positive results on an HIV-1/HIV-2 antibody or HIV-1/HIV-2 antigen/antibody immunoassay. They should be tested with a supplemental HIV-1/HIV-2 antibody differentiation assay. If they have only HIV-2 infection, the test will be negative for HIV-1 antibodies and positive for HIV-2 antibodies (AII).
  • Pregnant women living with HIV-1/HIV-2 coinfection should be treated as per guidelines for HIV-1 monoinfection, but using antiretroviral drugs that are active against HIV-2 (see below).
  • No randomized clinical trials have been performed to address when to start treatment or what the optimal treatment is for HIV-2 infection (AIII). A regimen with two nucleoside reverse transcriptase inhibitors and certain boosted protease inhibitors or integrase strand transfer inhibitors is recommended for all pregnant women living with HIV-2 infection (AIII).
  • Non-nucleoside reverse transcriptase inhibitors and enfuvirtide are not active against HIV-2 and should not be used (AIII).
  • All infants born to mothers living with HIV-2 infection should receive the 4-week zidovudine prophylactic regimen (BIII).
  • In the United States, where safe infant formula is readily available, breastfeeding is not recommended for infants of mothers living with HIV-2 infection (AIII).
Rating of Recommendations: A = Strong; B = Moderate; C = Optional
Rating of Evidence: I = One or more randomized trials with clinical outcomes and/or validated laboratory endpoints; II = One or more well-designed, nonrandomized trials or observational cohort studies with long-term clinical outcomes; III = Expert opinion

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