Updated US perinatal guidelines (2006)

The Public Health Service Task Force Recommendations for Use of Antiretroviral Drugs in Pregnant HIV-1-Infected Women for Maternal Health and Interventions to Reduce Perinatal HIV-1 Transmission in the United States has been revised to include an update of the “Antiretroviral Drug Resistance and Resistance Testing in Pregnancy” section to reflect new recommendations for resistance testing for HIV-infected pregnant women.

The Perinatal Working Group now recommends resistance testing for 1) all pregnant women not currently receiving antiretrovirals, before starting treatment or Mother To Child Transmission (MTCT) prophylaxis, and 2) all pregnant women receiving antenatal antiretroviral therapy who have virologic failure or who have sub-optimal viral suppression after initiation of antiretroviral therapy.

The Working Group also counsels against adding single-dose maternal/infant NVP to an ongoing highly active antiretroviral regimen, as this does not provide additional efficacy in reducing perinatal transmission and may result in NVP drug resistance in the mother.

Information in Table 6 from the November 17, 2005 document has been updated and replaced with a recommendation box at the beginning of the “Antiretroviral Drug Resistance and Resistance Testing in Pregnancy” section; the old Table 6 has been removed and the remaining tables have been renumbered accordingly.

The updated section and new references are highlighted in the document.

The document is available in the “Guidelines” section of the AIDSinfo Web site under “Perinatal Guidelines

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