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Case Records of the Massachusetts General Hospital
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Volume 353:1725-1732 October 20, 2005 Number 16
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Case 32-2005 — A 34-Year-Old HIV-Positive Woman Who Desired to Become Pregnant
Laura E. Riley, M.D., and Sigal Yawetz, M.D.

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Presentation of Case

A 34-year-old woman who was infected with the human immunodeficiency virus (HIV) was evaluated in the infectious-disease and obstetrics outpatient divisions because of a desire to become pregnant.

HIV infection had been diagnosed nine years earlier while the patient was undergoing treatment for cervical dysplasia at another hospital. She believed that she had been infected through heterosexual contact with a previous boyfriend. Two years later, she transferred her care to this hospital. She was asymptomatic and was taking no medications. Laboratory-test results on evaluation are shown in Table 1. She had no other medical problems. She lived with her . . . [Full Text of this Article]

Discussion of Management

Prepregnancy Consultation

            Maternal Risk Factors for Mother-to-Child HIV Transmission

            Treating Maternal HIV Infection

            Goals of Antiretroviral Therapy

            Choosing Antiretroviral Agents

            Starting Antiretroviral Treatment

            Monitoring for Efficacy and Toxic Effects

Labor and Delivery

            Cesarean or Vaginal Delivery

            Management of Antiretroviral Therapy during and after Delivery

Treatment and Monitoring of the Infant

Diagnosis


Source Information

From the Obstetrics and Gynecology Service, Massachusetts General Hospital (L.E.R.); the Division of Infectious Diseases, Brigham and Women's Hospital (S.Y.); and the Departments of Obstetrics, Gynecology, and Reproductive Biology (L.E.R.) and Medicine (S.Y.), Harvard Medical School — all in Boston.


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