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HIV in pregnancy
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The rate of progression of HIV to AIDS is probably not affected by pregnancy.
The rate of vertical transmission is about 15-35%. In Europe it is nearer 15% and in Africa nearer 30%.
Zidovudine appears to reduce vertical transmission by 2/3.
Nearly all babies born to HIV antibody positive mothers will get antibody to HIV via transplacental transfer. Only 15-35% of these will also be infected by the virus itself. It follows that detection of HIV antibody in neonates does not necessarily indicate HIV infection. HIV infection can be diagnosed by detection of HIV p24 antigen or detection of HIV antibody at age 18 months. In developing countries it may be necessary to make the diagnosis on clinical grounds.
The rate of vertical transmission is increased by breast feeding and vaginal delivery. It is also increased if the mother has advanced disease.
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