Manejo integral de la gestante con Virus de la Inmunodeficiencia Humana

Autores/as

  • Camilo Rada-Ortega
  • Jorge Mario Gómez-Jiménez

DOI:

https://doi.org/10.18597/rcog.270

Palabras clave:

VIH, embarazo, neonato, lactancia, anticoncepción

Resumen

Objetivo: revisar los aspectos más relevantes del manejo de la gestante con virus de inmunodeficiencia humana (VIH) antes, durante y después del parto. También se incluyen las medidas básicas de cuidado al recién nacido.

Metodología: se realizó una revisión de las publicaciones en MEDLInE entre enero de 2000 y junio de 2009 sobre el tema. Asimismo, se abordaron las guías de manejo del Ministerio de Protección Social de Colombia y las pertenecientes a los Centros para el Control de Enfermedades de los EE.UU. de América.

Resultados: la oportuna prescripción de la terapia antirretroviral de alta efectividad durante el control prenatal, la utilización de profilaxis antirretroviral anteparto, la realización de cesárea anteparto, evitar la lactancia materna y la profilaxis neonatal son las medidas que evitarán casi al 100% la transmisión madre-hijo del VIH.

Conclusión: el manejo actualmente recomendado permite la prevención de la transmisión madre-hijo del VIH en la mayoría de los casos.

Biografía del autor/a

Camilo Rada-Ortega

Estudiante del nivel XI de Medicina. Facultad de Medicina de la Universidad de Antioquia. Medellín (Colombia).

Jorge Mario Gómez-Jiménez

Profesor Asociado, Especialista en Obstetricia y Ginecología. Facultad de Medicina de la Universidad de Antioquia. Medellín (Colombia).

Referencias bibliográficas

Aberg JA, Kaplan JE, Libman H, Emmanuel P, Anderson JR, Stone VE, et al. Primary care guidelines for the management of persons infected with human immunodeficiency virus: 2009 update by the HIV medicine Association of the Infectious Diseases Society of America. Clin Infect Dis 2009;49:651-81.

Connor EM, Sperling RS, Gelber R, Kiselev P, Scott G, O'Sullivan MJ, et al. Reduction of maternal-infant transmission of human immunodeficiency virus type 1 with zidovudine treatment. Pediatric AIDS Clinical Trials Group Protocol 076 Study Group. N Engl J Med 1994;331:1173-80.

ACOG committee opinion scheduled cesarean delivery and the prevention of vertical transmission of HIV infection. number 219, August 1999. Committee on Obstetric Practice. American College of Obstetricians and Gynecologists. Int J Gynaecol Obstet 2001;73:279-81.

Centers for Disease Control and Prevention (CDC). Achievements in public health. Reduction in perinatal transmission of HIV infection-United States, 1985-2005. MMWR Morb Mortal Wkly Rep 2006;55:592-7.

UNAIDS. 2006 Report on the global AIDS epidemic: a UnAIDS 10th anniversary special edition. Visitado en 2009 Sep 16. Disponible en http://www.unaids.org/en/KnowledgeCentre/HIVData/EpiUpdate/EpiUpdArchive/2006/default.asp

Chen JL, Philips KA, Kanouse DE, Collins RL, Miu A. Fertility desires and intentions of HIV-positive men and women. Fam Plann Perspect 2001;33:144-52, 165.

Ogilvie GS, Palepu A, Remple VP, Maan E, Heath K, MacDonald G, et al. Fertility intentions of women of reproductive age living with HIV in British Columbia, Canada. AIDS 2007;21:S83-8.

UNAIDS. Bangkok. 2004 Report on the global AIDS epidemic: 4th global report. Visitado 2009 Sep 16. Disponible en http://www.unaids.org/bangkok2004/gar2004_html/GAR2004_00_en.htm.

De Cock KM, Fowler MG, Mercier E, de Vincenzi I, Saba J, Hoff E, et al. Prevention of mother-tochild HIV transmission in resource-poor countries: translating research into policy and practice. JAMA 2000;283:1175-82.

Saada M, Le Chanadec J, Berrebi A, Bongain A, Delfraissy JF, Mayaux MJ, et al. Pregnancy and progression to AIDS: results of the French prospective cohorts. SEROGEST and SEROCO Study Groups. AIDS 2000;14:2355-60.

Penn Z, Dixit, A. Human immunodeficiency virus infection in Pregnancy. Current Obstetrics & Gynaecology 2006;16:191-8.

Brocklehurst P, French R. The association between maternal HIV infection and perinatal outcome: a systematic review of the literature and meta-analysis. Br J Obstet Gynaecol 1998;105:836-48.

Stratton P, Tuomala RE, Abboud R, Rodriguez E, Rich K, Pitt J, et al. Obstetric and newborn outcomes in a cohort of HIV-infected pregnant women. A report of the women and infants transmission study. J Acquir Immune Defic Syndr Hum Retrovirol 1999;20:179-86.

Lorenzi P, Spicher VM, Laubereau B, Hirschel B, Kind C, Rudin C, et al. Antiretroviral therapies in pregnancy: maternal, fetal and neonatal effects. Swiss HIV Cohort Study, the Swiss Collaborative HIV and Pregnancy Study and the Swiss neonatal HIV Study. AIDS 1998;12:F241-7.

Ministerio de Protección Social, Colombia; 2007. Guía para el manejo de VIH/SIDA basada en la evidencia. Visitado en 2009 Sep 16. Disponible en: http://www.pos.gov.co/Paginas/guiadeatenciondelvihsida.aspx

Betancur J. Infección VIH y embarazo. En: 13º curso de actualización en obstetricia y ginecología. Facultad de Medicina. Universidad de Antioquia; 2006. p. 83-90.

AIDSinfo. 2009 Public Health Service Task Force. Recommendations for Use of Antiretroviral Drugs in Pregnant HIV-Infected Women for Maternal Health and Interventions to Reduce Perinatal HIV Transmission in the United States. Visitado en 2009 Sep 16. Disponible en http://aidsinfo.nih.gov/contentfiles/Peri_Tables.pdf

Committee on Obstetric Practice. ACOG committee opinion scheduled Cesarean deliver y and the prevention of vertical transmission of HIV infection. number 234, May 2000 (replaces number 219, August 1999). Int J Gynaecol Obstet 2001;73:279-81.

Shapiro D, Tuomala R, Samelson R, Burchett S, Ciupak G. Mcnamara J, et al. Mother-to-child HIV transmission rates according to antiretroviral therapy, mode of delivery, and viral load (PACTG 367). Abstract 114, 9th Conference on Retroviruses and Opportunistic Infections. 2002 Feb 24-28, Seattle, WA, U.S.A.

American College of Obstetricians and Gynecologists. ACOG practice bulletin number 47, October 2003: Prophylactic Antibiotics in Laborand Delivery.Obstet Gynecol 2003;102:875-82.

ACOG educational bulletin. Assessment of fetal lung maturity. Number 230, November 1996. Committee on Educational Bulletins of the American College of Obstetricians and Gynecologists. Int J Gynaecol Obstet 1997;56:191-8.

ACOG educational bulletin. Antimicrobial therapy for obstetric patients. Number 245, March 1998 (replaces no. 117, June 1988). American College of Obstetricians and Gynecologists. Int J Gynaecol Obstet, 1998;61:299-308.

Nielsen TF, Hokegard KH. Postoperative cesarean section morbidity: a prospective study. Am J Obstet Gynecol 1983;146:911-5.

Hebert PR, Reed G, Entman SS, Mitchel EF Jr, Berg C, Griffin MR. Serious maternal morbidity after childbirth: prolonged hospital stays and readmissions. Obstet Gynecol 1999;94:942-7.

Dunn DT, newell ML, Ades AE & Peckham CS. Risks of human immunodeficiency virus type 1 transmission through breast feeding. Lancet 1992;340:585-8.

Royal College of Obstetricians and Gynaecologists. Management of HIV in Pregnancy. Greentop Guideline no. 39, April 2004.

Centers for Disease Control and Prevention. Report of the nIH panel to define principles of therapy of HIV infection and guidelines for the use of antiretroviral agents in HIV-infected adults and adolescents. MMWR Morb Mortal Wkly Rep 1998;47:1-82.

Nduati R, John G, Mbori-ngacha D, Richardson B, Overbaugh J, Mwatha A, et al. Effect of breastfeeding and formula feeding on transmission of HIV-1: a randomized clinical trial. JAMA 2000;283:1167-74.

Howie PW, Forsyth JS, Ogston SA, Clark A, Florey CD. Protective effect of breastfeeding against infection. BMJ 1990;300:11-6.

Young TK, Martens PJ, Taback SP, Sellers EA, Dean HJ, Cheang M, et al. Type 2 diabetes mellitus in children: prenatal and early infancy risk factors among native Canadians. Arch Pediatr Adolesc Med 2002;156:651-5.

Owen CG, Whipcup PH, Odoki K, Gilg JA, Cook DG. Infant feeding and blood cholesterol: a study in adolescents and systematic review. Pediatrics 2002;110:597-608.

Duncan B, Ey J, Holberg CJ, Wright AL, Martínez FD, Taussig LM. Exclusive breastfeeding for at least 4 months protects against otitis media. Pediatrics 1993;91:867-72.

UNAIDS. 2000 Report of the Global HIV/AIDS Epidemic. Visitado en 2009 Sep 16. Disponible en: http://www.aegis.com/files/unaids/WADDecember2000_epidemic_report.pdf

UNICEF. The State of the World's Children 1997. Visitado 2009 Sep 16. Disponible en http://www.unicef.org/publications/files/pub_sowc97_en.pdf

Lawrence RA. Breastfeeding. A guide for the medical profession. 4th ed. St Louis, MO: Mosby; 1994.

Lucas A, Morley R, Cole TJ, Lister G, Leeson-Payne C. Breast milk and subsequent intelligence quotient in children born preterm. Lancet 1992;339:261-4.

Lanting CI, Fidler V, Huisman M, Touwen BC, Boersma ER, et al. neurological differences between 9-year-old children fed breast-milk or formula-milk as babies. Lancet 1994;344:1319-22.

Fowler MG & newell ML. Breast-feeding and HIV-1 transmission in resource-limited settings. J Acquir Immune Defic Syndr 2002;30:230-9.

John-Stewart G, Mbori-Ngnacha D, Ekpini R, Janoff EN, Nkengasong J, Read JS, et al. Breast-feeding and transmission of HIV-1. J Acquir Immune Defic Syndr 2004;35:196-202.

Cutsoidis A. Breastfeeding and HIV. Best Pract Res Clin Obstet Gynaecol 2005;19:185-96.

American Academy of Pediatrics. Comittee on Pediatric AIDS. Evaluation and medical treatment of the HIVexposed infant. Pediatrics 1997;99:909-17.

British HIV Association. Guidelines for the management of HIV infection in pregnant women and the prevention of mother-to child transmission of HIV. Visitado en 2009 Sep 16. Disponible en: http://www.bhiva.org

European Collaborative Study. Swiss mother, child HIV Cohort Study. Combination antiretroviral therapy, duration of pregnancy. AIDS 2002;14:1913-20.

Atkinson WL, Pickering LK, Schwartz B, Weniger BG, Iskander JK, Watson JC; Centers for Disease Control and Prevention. General Recommendations on Immunization. Recommendations oftheAdvisory Comittee on Immunization Practices (ACIP) and the American Academy of Family Physicians (AAFP). MMWR Recomm Rep 2002;51:1-35.

Recomendaciones de GESIDA/Plan Nacional sobre el Sida respecto al tratamiento antirretroviral en adultos infectados por el virus de la inmunodeficiencia humana (actualización enero de 2007); Panel de expertos de GESIDA y Plan nacional sobre el Sida. Enferm Infecc Microbiol Clin 2007;25:32-53.

Panel on Clinical Practices for Treatment of HIV Infection convened by the U.S. Department of Health and Human Services (DHHS). Guidelines for the use of antiretroviral agents in HIV-infected adults and adolescents -Oct 10, 2006. Visitado en 2009 Sep 16. Disponible en: http://AIDSinfo.nih.gov

Gazzard B. British HIV Association (BHIVA) guidelines for the treatment of HIV-infected adults with antiretroviral therapy (2005). HIV Med 2005;6 Suppl 2:1-61.

Hammer SM, Saag MS, Schechter M, Montaner JS, Schooley RT, Jacobsen DM, et al. Treatment for adult HIV infection: 2006 recommendations of the International AIDS Society-USA panel. JAMA 2006;296:827-43.

Minkoff H, Augenbraun M. Antiretroviral therapy for pregnant women. Am J Obstet Gynecol 1997;176:478-89.

Lyons F, Hopkins S, Kelleher B, McGeary A, Sheehan G, Geoghegan, J, et al. Maternal hepatotoxicity with evirapine as part of combination antiretroviral therapy in pregnancy. HIV Med 2006;7:255-60.

Hitti J, Frenkel LM, Stek AM, Nachman SA, Baker D, Gonzalez-Garcia A, et al. Maternal toxicity with continuous nevirapine in pregnancy: results from PACTG 1022. J Acquir Immune Defic Syndr 2004;36:772-6.

Cómo citar

1.
Rada-Ortega C, Gómez-Jiménez JM. Manejo integral de la gestante con Virus de la Inmunodeficiencia Humana. Rev. colomb. obstet. ginecol. [Internet]. 30 de septiembre de 2010 [citado 29 de marzo de 2024];61(3):239-46. Disponible en: https://revista.fecolsog.org/index.php/rcog/article/view/270

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2010-09-30

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