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Human Immunodeficiency Virus

  • Roulhac D. Toledano
Chapter

Abstract

The human immunodeficiency virus affects 37 million individuals, including 17.8 million women, worldwide. Currently, one out of every four patients living with HIV in the United States is a woman, with minority women affected disproportionately. Without treatment, an estimated 25% of children born to HIV-infected women will become infected. This chapter reviews obstetric strategies to reduce mother-to-child transmission in the peripartum period, as well as analgesic and anesthetic management options for HIV-infected women during labor and delivery (vaginal or cesarean). It also reviews treatment options for post-dural puncture headache and strategies to optimize health-care worker safety when providing care for HIV-infected individuals.

Keywords

Human immunodeficiency virus (HIV) HIV in pregnancy Mother-to-child-transmission (MTCT) HIV screening Opt-out testing Diagnostic HIV tests Accidental dural puncture (ADP) Anesthetic management of patients with HIV Antiretroviral therapy (ART) Zidovudine (ZDV, AZT) Highly active antiretroviral therapy (HAART) Neuraxial analgesia and anesthesia Post-dural puncture headache (PDPH) Epidural blood patch (EBP) 

Abbreviations

ADP

Accidental dural puncture

ART

Antiretroviral therapy

AZT

Zidovudine

CNS

Central nervous system

CSE

Combined spinal-epidural

CSF

Cerebrospinal fluid

EBP

Epidural blood patch

EFV

Efavirenz

FIs

Fusion inhibitors

HAART

Highly active antiretroviral therapy

HCW

Health-care worker

HIV

Human immunodeficiency virus

INSTIs

Integrase strand transfer inhibitors

ITP

Immune thrombocytopenic purpura

LFTs

Liver function tests

MAC

Mycobacterium avium complex

MTCT

Maternal-to-child transmission

NNRTIs

Non-nucleoside reverse transcriptase inhibitors

NRTIs

Nucleoside/nucleotide reverse transcriptase inhibitors

PCP

P. carinii pneumonia

PDPH

Post-dural puncture headache

PIs

Protease inhibitors

SJS

Stevens-Johnson syndrome

TB

Tuberculosis

ZDV

Zidovudine

References

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Roulhac D. Toledano
    • 1
  1. 1.Department of AnesthesiologyPreoperative Care, and Pain Medicine, NYU Langone Hospital – BrooklynBrooklynUSA

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