Human immunodeficiency virus infection in pregnancy

Many aspects of HIV infection in pregnancy remain unclear. Subsets at increased risk for perinatal transmission, adverse pregnancy outcome, and development of symptomatic HIV infection need to be identified. For instance, relative risks may be quite different in asymptomatic HIV infected patients with T4 lymphocyte counts greater than 200 cells per cubic millimeter compared to those with either symptoms of HIV infection or T4 cell counts less than 200 cells per cubic millimeter. At present, antiviral therapeutic trials do not include pregnant women or neonates less than 3 months of age. In the future, antiviral therapy with agents, such as AZT, may reduce the risk of transplacental and intrapartum HIV transmission. Obstetricians will be involved increasingly in providing care to HIV-infected patients and educating patients in order to prevent HIV infection.