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Essentials of Management of Pregnancy in HIV-Infected Women: A Handbook for Obstetricians and Gynecologists
Narendra Malhotra
SECTION 1: INTRODUCTION
CHAPTER 1:
Prevention of Perinatal Transmission—An Overview
SECTION 2: VIROLOGY
CHAPTER 2:
Origin and Discovery of HIV
CHAPTER 3:
Structure and Genome
CHAPTER 4:
Classification of HIV
CHAPTER 5:
HIV Life Cycle
CHAPTER 6:
Transmission
SECTION 3: DIAGNOSIS OF HIV-INFECTION
CHAPTER 7:
HIV Testing in Pregnant Women
FOUR GUIDING PRINCIPLES FOR HIV TESTING FOR PMTCT
Voluntary
Informed Consent
Confidentiality
Post-Test Counseling Support and Services
TEST FOR HIV TESTING
HIV TESTING DURING PREGNANCY
SECTION 4: ANTIRETROVIRAL THERAPY
CHAPTER 8:
Overview Antiretroviral Drugs and Regimens
NON-NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS
PROTEASE INHIBITORS
ENTRY INHIBITORS
CCR5 CO-RECEPTOR INHIBITOR
INTEGRASE INHIBITOR
RECOMMENDED PREFERRED AND ALTERNATIVE REGIMENS
ANTIRETROVIRAL REGIMENS, STRATEGIES OR COMPONENTS NOT RECOMMENDED
ANTIRETROVIRAL STRATEGIES, WHICH ARE NOT RECOMMENDED
CHAPTER 9:
Specific Recommendations for Use of Antiretroviral Therapy in Pregnancy
SPECIAL RISK WITH ANTIRETROVIRAL THERAPY DURING PREGNANCY
ADVERSE ANTIRETROVIRAL DRUG EVENTS DURING PREGNANCY
CHAPTER 10:
Antiretroviral Therapy and Patient
APPROACHING THE PATIENT (Patient-related strategies)
CLINICIAN AND HEALTH TEAM-RELATED STRATEGIES
CHAPTER 11:
Adherence to Antiretroviral Therapy
KEY POINTS
What happens to adherence over time?
How Resistance Develops?
SECTION 5: CONCEPTION
CHAPTER 12:
Methods of Conception in HIV-Infected Patients
SECTION 6: PREGNANCY AND HIV-INFECTION
CHAPTER 13:
Impact of Pregnancy on Maternal Health and on Therapy of HIV
CHAPTER 14:
Factors Affecting Mother-to-Child Transmission of HIV
SECTION 7: COMPREHENSIVE EVALUATION AND LABORATORY MONITORING OF THE HIV-INFECTED PREGNANT WOMEN
CHAPTER 15:
Recommended Evaluation and Routine Monitoring of the HIV-Infected Pregnant Woman during Pregnancy, Labor and Delivery
SECTION 8: RECOMMENDATION ON USE OF ANTIRETROVIRAL THERAPY IN HIV-INFECTED PREGNANT WOMEN (BASED ON DIFFERENT CLINICAL PRESENTATION)
CHAPTER 16:
General Principles Regarding Use of Antiretroviral Drugs during Pregnancy
MANAGEMENT OF HIV-INFECTED PREGNANT WOMEN: KEY CONCEPTS
CHAPTER 17:
Recommendations for Use of Antiretroviral Drugs during Pregnancy
GUIDELINES FOR USE OF ANTIRETROVIRAL THERAPY IN PREGNANCY
CHAPTER 18:
Case Presentation 1 A Pregnant Woman Who is Detected to be HIV +ve for the First Time in Current Pregnancy and her CD4 Count is Less than 250/mm3
CHAPTER 19:
Case Presentation 2 A Pregnant Woman Who is Detected to be HIV +ve for the First Time in Current Pregnancy and her CD4 Count is More than 250/mm3
STOPPING ANTIRETROVIRAL THERAPY AFTER DELIVERY OR DURING PREGNANCY
CHAPTER 20:
Case Presentation 3 HIV-Infected Woman Who Becomes Pregnant While Taking Antiretroviral Therapy
CHAPTER 21:
Case Presentation 4 A Pregnant Woman Who is Detected to be HIV+ve at the Time of Labor
NEVIRAPINE MONOTHERAPY WITH PRESENTATION IN LABOR
CHAPTER 22:
Case Presentation 5 An Infant is Born to an HIV-Infected Woman Who Has Received to Antiretroviral Therapy during Pregnancy or in the Intrapartum Period
RECOMMENDATIONS FOR NEONATAL ANTIRETROVIRAL THERAPY
SECTION 9: HIV-INFECTED WOMEN AND ROUTE OF DELIVERY
CHAPTER 23:
Perinatal HIV Transmission and Route of Delivery
IMPACT OF CESAREAN SECTION ON PERINATAL HIV TRANSMISSION
INDICATIONS FOR CESAREAN SECTION
TIMING OF PLANNED CESAREAN SECTION
SCHEDULED CESAREAN SECTION AND ANTIRETROVIRAL THERAPY
SCHEDULED CESAREAN SECTION AND WOMAN PRESENTS IN LABOR
COMPLICATIONS OF CESAREAN SECTION
SECTION 10: MANAGEMENT AND MONITORING OF NEONATES BORN TO HIV-INFECTED MOTHERS
CHAPTER 24:
Neonatal Antiretroviral Therapy
RECOMMENDATIONS FOR NEONATAL ANTIRETROVIRAL THERAPY
CHAPTER 25:
HIV Testing and Laboratory Monitoring of the Neonate
PREFERRED VIROLOGIC ASSAYS
DNA PCR Vs RNA ASSAYS
DIAGNOSTIC TESTING IN INFANTS
CHAPTER 26:
Infant Feeding
INFANT FEEDING CHOICES
ANTIRETROVIRAL THERAPY AND BREAST FEEDING
SECTION 11: TREATMENT AND PROPHYLAXIS OF OPPORTUNISTIC INFECTIONS DURING PREGNANCY
CHAPTER 27:
Opportunistic Infection Prophylaxis
CHAPTER 28:
Special Considerations for OI Prophylaxis during Pregnancy
TRIMETHOPRIM-SULFAMETHOXAZOLE
GENITAL HERPES
TOXOPLASMOSIS
SECTION 12: CONTRACEPTION FOR HIV-INFECTED WOMEN
CHAPTER 29:
Contraception
ANTIRETROVIRALS AND ORAL CONTRACEPTIVES
ORAL CONTRACEPTIVES AND NNRTIS
ORAL CONTRACEPTIVES AND PIS
ORAL CONTRACEPTIVES AND ANTIRETROVIRALS: RECOMMENDATIONS
SECTION 13: UNIVERSAL WORK PRECAUTION AND PEP FOR HIV
CHAPTER 30:
Universal Work Precautions
IMPORTANCE OF UNIVERSAL PRECAUTIONS
UNIVERSAL PRECAUTIONS
Protective Barriers
Safe Handling of Sharps
ENSURING UNIVERSAL PRECAUTIONS
Understanding of Universal Precautions by HCWs
Reduce Unnecessary Procedures
Make Adequate Supplies Available
Ensure Adherence to Universal Precautions
CHAPTER 31:
Post-exposure Prophylaxis for HIV Following Needle Stick Injury
KEY CONCEPTS
EXPOSURES PRESENTING A RISK FOR TRANSMISSION
POST-EXPOSURE PROPHYLAXIS (PEP) FOLLOWING NEEDLE STICK INJURY
Needle Stick Injury
Exposure Reporting
Management of Exposure Site
CLINICAL EVALUATION
Assessment of Exposure and Source Patient
INITIAL ASSESSMENT OF EXPOSED
Selecting a Chemoprophylaxis Regimen
Adherence to Prophylaxis Regimen
Duration of Post-exposure Prophylaxis Regimen
Follow-up
Side Effects/Toxicity
Advisability of Expert Consultation
Pre-exposure Prophylaxis (PrEP)
CHAPTER 32:
Stigma and Discrimination in Health Care Settings: Need of Sensitization
SECTION 14: ANNEXURE
ANNEXURE 1:
HIV Classification System
ANNEXURE 2:
Preclinical and Clinical Data Relevant to the Use of Antiretrovirals during Pregnancy
References
INDEX
TOC
Index
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