Human Immunodeficiency Virus Infection

AIDS Symbol - The Red Ribbon

The Wrath of AIDS

Definition

• HIV is the causative agent for acquired immunodeficiency syndrome (AIDS)
• Considered as an STD, it can have serious implications for the pregnant mother and her fetus.

The story behind it

• HIV infection is caused by a retrovirus that targets the helper T-lymphocytes that contain the CD4+ antigen.
• The virus integrates itself into the cell's genetic makeup, ultimately causing cellular dysfunction;
• The cells can no longer function in mounting an appropriate immune response, leaving the person vulnerable to opportunistic infections.
• The virus may be contracted through sexual intercourse, exposure to infected blood, vertical transmission across the placenta to the fetus during pregnancy, labor and delivery birth, or by breast milk to the neonate.

The clinical manifestations

• Lymphadenopathy
• Bacterial pneumonia
• Fever
• Night sweats
• Weight loss
• Dermatologic problems
• Thrush
• Thrombocytopenia;
• Diarrhea
• Severe vaginal yeast infection that is difficult to treat
• Abnormal pap smear result
• Frequent HPV infections, frequent and recurrent bacterial vaginosis, trichomonas, and genital herpes infections.

The test for AIDS

• Two positive enzyme-linked immunosorbent assays confirmed with the western blot test identifies the person as being positive for HIV
• CD4+ T-lymphocyte count is less than 200 cells/ul

How is it managed?

• Combination antiretroviral therapy in an attempt to reduce the mother's viral load and thus minimize the risk of vertical transmission of the infection to the fetus
• Supportive care

How is it intervened?

• Institute standard precautions when caring for the mother throughout the pregnancy and after delivery and when caring for the neonate;
• Teach the pregnant mother about the measures to minimize the risk of virus transmissions;
• Provide emotioanl support and guidance for the infected individual who is HIV positive and considering pregnancy;
• Allow the pregnant mother who is discovered to be HIV positive to verbalize her feelings and provide support for her;
• Monitor CD4+ T-lymphocyte counts and viral loads as indicated;
• Assess the infected individual for signs and symptoms of opportunistic infections;
• Encourage them to maintain prenatal follow-up to evauluate the status of pregnancy;
• Administer antiretroviral therapy as indicated:
• Teach the pregnanat mother how to administer the therapy;
• Assist with scheduling medications;
• Evaluate the mother for compliance on return visits
• Institute measures during labor and delivery to minimize the fetus's risk of exposure to maternal blood or body fluids;
• Avoid the use of internal fetal monitors, scalp blood sampling, forceps, and vacuum extraction to prevent the creation of an open lesion on the fetal scalp;
• Advise the mother that breast-feeding is not recommended because of the risk of possible virus transmission;
• Withhold blood sampling and injections on the neonate until maternal blood has been removed with the first bath;
• Educate the mother about the mode of HIV transmission and safer sex practices.