Pregnant women have their blood taken for HIV. Therapy in patients who have previously received antiviral drugs

This is a chronic progressive infection, caused by a pathogen from the group of retroviruses and occurring before the conception of the child or during the gestational period. It remains latent for a long time. During the initial reaction, it is manifested by hyperthermia, skin rash, damage to the mucous membranes, transient enlargement of the lymph nodes, and diarrhea. Subsequently, generalized lymphadenopathy occurs, weight gradually decreases, and HIV-associated disorders develop. Diagnosed by laboratory methods (ELISA, PCR, cellular immunity study). Antiretroviral therapy is used to treat and prevent vertical transmission.

ICD-10

O98.7 B20-B24

General information

HIV infection is a strict anthroponosis with a parenteral, non-transmissible mechanism of infection from an infected person. Over the past 20 years, the number of newly diagnosed infected pregnant women has increased almost 600 times and exceeded 120 per 100 thousand examined. Most women of childbearing age became infected through sexual contact; the proportion of HIV-positive patients with drug addiction does not exceed 3%. Thanks to compliance with the rules of asepsis, sufficient antiseptic treatment of instruments for invasive procedures and effective serological control, it was possible to significantly reduce the incidence of infection as a result of occupational injuries, blood transfusions, due to the use of contaminated instruments and donor materials. In more than 15% of cases, it is not possible to reliably determine the source of the pathogen and the mechanism of infection. The relevance of special support for HIV-infected pregnant women is due to the high risk of infection of the fetus in the absence of adequate restraining treatment.

Causes

The causative agent of the disease is a human immunodeficiency retrovirus of one of two known types - HIV-1 (HIV-1) or HIV-2 (HIV-2), represented by many subtypes. Typically, infection occurs before the onset of pregnancy, less often - at the time or after the conception of a child, during gestation, childbirth, and the postpartum period. The most common route of transmission of an infectious agent in pregnant women is natural (sexual) through the secretions of the mucous membranes of an infected partner. Infection is possible through intravenous administration of narcotic drugs, violation of aseptic and antiseptic standards during invasive procedures, and performance of professional duties with the possibility of contact with the blood of the carrier or patient (health workers, paramedics, cosmetologists). During pregnancy, the role of some artificial routes of parenteral infection increases, and they themselves acquire certain specifics:

• Blood transfusion infection. With complicated pregnancy, childbirth and the postpartum period, the likelihood of blood loss increases. Treatment regimens for the most severe bleeding involve the administration of donor blood and drugs derived from it (plasma, red blood cells). HIV infection is possible when using material tested for the virus from an infected donor in the case of blood sampling during the so-called seronegative incubation window, which lasts from 1 week to 3-5 months from the moment the virus enters the body.
• Instrumental contamination. Pregnant patients are more likely than non-pregnant patients to undergo invasive diagnostic and therapeutic procedures. To exclude fetal developmental anomalies, amnioscopy, amniocentesis, chorionic villus biopsy, cordocentesis, and placentocentesis are used. For diagnostic purposes, endoscopic examinations (laparoscopy) are performed, and for therapeutic purposes, suturing of the cervix, fetoscopic and fetal drainage operations are performed. Infection through contaminated instruments is possible during childbirth (when suturing injuries) and during caesarean section.
• Transplant route of transmission of the virus. Possible options solutions for couples planning pregnancy with severe forms of male infertility are insemination with donor sperm or its use for IVF. As with blood transfusions, there is a risk of infection in such situations when using infected material obtained during the seronegative period. Therefore, for preventive purposes, it is recommended to use sperm from donors who have successfully passed an HIV test six months after donating the material.

Pathogenesis

The spread of HIV throughout the body occurs through the blood and macrophages, into which the pathogen initially penetrates. The virus has a high tropism for target cells, the membranes of which contain the specific protein receptor CD4 - T-lymphocytes, dendritic lymphocytes, some monocytes and B-lymphocytes, resident microphages, eosinophils, bone marrow cells, nervous system, intestines, muscles, vascular endothelium, choriontrophoblast of the placenta, possibly sperm. After replication, a new generation of the pathogen leaves the infected cell, destroying it.

Immunodeficiency viruses have the greatest cytotoxic effect on type I T4 lymphocytes, which leads to depletion of the cell population and disruption of immune homeostasis. A progressive decrease in immunity worsens the protective characteristics of the skin and mucous membranes, reduces the effectiveness of inflammatory reactions to the penetration of infectious agents. As a result, in the final stages of the disease, the patient develops opportunistic infections caused by viruses, bacteria, fungi, helminths, protozoal flora, typical AIDS tumors (non-Hodgkin's lymphoma, Kaposi's sarcoma) arise, and autoimmune processes begin, ultimately leading to the death of the patient.

Classification

Domestic virologists use in their work the systematization of the stages of HIV infection proposed by V. Pokrovsky. It is based on the criteria of seropositivity, severity of symptoms, and the presence of complications. The proposed classification reflects gradual development infections from the moment of infection to the final clinical outcome:

• Incubation stage. HIV is present in the human body, its active replication occurs, but antibodies are not detected, and there are no signs of an acute infectious process. The duration of seronegative incubation is usually from 3 to 12 weeks, while the patient is infectious.
• Early HIV infection. The body's primary inflammatory response to the spread of the pathogen lasts from 5 to 44 days (in half of the patients - 1-2 weeks). In 10-50% of cases, the infection immediately takes the form of asymptomatic carriage, which is considered a more prognostically favorable sign.
• Stage sub clinical manifestations . Viral replication and destruction of CD4 cells lead to a gradual increase in immunodeficiency. Generalized lymphadenopathy becomes a characteristic manifestation. The latent period of HIV infection lasts from 2 to 20 years or more (on average 6-7 years).
• Stage of secondary pathology. Depletion of protective forces is manifested by secondary (opportunistic) infections and oncopathology. The most common AIDS-indicating diseases in Russia are tuberculosis, cytomegalovirus and candidiasis infections, Pneumocystis pneumonia, toxoplasmosis, and Kaposi's sarcoma.
• Terminal stage. Against the background of severe immunodeficiency, severe cachexia is observed, there is no effect from the therapy used, and the course of secondary diseases becomes irreversible. The duration of the final stage of HIV infection before the death of the patient is usually no more than several months.

Practicing obstetricians and gynecologists often have to provide specialized care to pregnant women in the incubation period, at an early stage of HIV infection or its subclinical stage, and less often when secondary disorders appear. Understanding the characteristics of the disease at each stage allows you to choose the optimal pregnancy management regimen and the most suitable method of delivery.

Symptoms of HIV in pregnant women

Since during pregnancy most patients develop stages I-III of the disease, pathological clinical signs are absent or appear nonspecific. During the first three months after infection, 50-90% of infected people experience an early acute immune reaction, which is manifested by weakness, a slight increase in temperature, urticarial, petechial, papular rash, inflammation of the mucous membranes of the nasopharynx and vagina. Some pregnant women have enlarged lymph nodes and develop diarrhea. With a significant decrease in immunity, short-term, mild candidiasis, herpetic infection, and other intercurrent diseases may occur.

If HIV infection occurred before pregnancy and the infection developed to the stage of latent subclinical manifestations, the only sign of the infectious process is persistent generalized lymphadenopathy. A pregnant woman has at least two lymph nodes with a diameter of 1.0 cm, located in two or more groups that are not interconnected. When palpated, the affected lymph nodes are elastic, painless, not connected to the surrounding tissues, skin above them have an unchanged appearance. The enlargement of nodes persists for 3 months or more. Symptoms of secondary pathology associated with HIV infection are rarely detected in pregnant women.

Complications

The most serious consequence of pregnancy in an HIV-infected woman is perinatal (vertical) infection of the fetus. Without adequate containment therapy, the likelihood of a child becoming infected reaches 30-60%. In 25-30% of cases, the immunodeficiency virus passes from mother to child through the placenta, in 70-75% - during childbirth when passing through an infected birth canal, in 5-20% - through breast milk. HIV infection in 80% of perinatally infected children develops rapidly, and AIDS symptoms appear within 5 years. Most characteristic features diseases are malnutrition, persistent diarrhea, lymphadenopathy, hepatosplenomegaly, developmental delay.

Intrauterine infection often leads to damage to the nervous system - diffuse encephalopathy, microcephaly, cerebellar atrophy, and deposition of intracranial calcifications. The likelihood of perinatal infection increases with acute manifestations of HIV infection with high viremia, a significant deficiency of T-helper cells, extragenital diseases of the mother (diabetes mellitus, cardiopathology, kidney disease), the presence of sexually transmitted infections in a pregnant woman, and chorioamnionitis. According to the observations of specialists in the field of obstetrics, patients infected with HIV are more likely to experience the threat of miscarriage, spontaneous miscarriages, premature births, and perinatal mortality increases.

Diagnostics

Taking into account the potential danger of the patient's HIV status for the unborn child and medical personnel, a test for the immunodeficiency virus is included in the list of recommended routine examinations during pregnancy. The main objectives of the diagnostic stage are to identify possible infection and determine the stage of the disease, the nature of its course, and prognosis. To make a diagnosis, the most informative laboratory research methods are:

• Linked immunosorbent assay. Used as a screening. Allows you to detect antibodies to the human immunodeficiency virus in the blood serum of a pregnant woman. In the seronegative period it is negative. It is considered a preliminary diagnostic method and requires confirmation of the specificity of the results.
• Immune blotting. The method is a type of ELISA; it makes it possible to determine in serum antibodies to certain antigenic components of the pathogen, distributed by molecular weight by phoresis. It is a positive immunoblot result that serves as a reliable sign of the presence of HIV infection in a pregnant woman.
• PCR diagnostics. Polymerase chain reaction is considered a method for early detection of the pathogen with a period of infection of 11-15 days. With its help, viral particles are detected in the patient’s serum. The reliability of the method reaches 80%. Its advantage is the ability to quantitatively control HIV RNA copies in the blood.
• Study of the main lymphocyte subpopulations. The probable development of immunosuppression is indicated by a decrease in the level of CD4 lymphocytes (T-helper cells) to 500/μl or less. The immunoregulatory index, which reflects the ratio between T-helpers and T-suppressors (CD8 lymphocytes), is less than 1.8.

When a previously unexamined pregnant woman from marginalized populations is admitted for childbirth, it is possible to conduct a rapid HIV test using highly sensitive immunochromatographic test systems. For routine instrumental examination of an infected patient, non-invasive diagnostic methods are preferred (transabdominal ultrasound, Dopplerography of uteroplacental blood flow, cardiotocography). Differential diagnosis at the stage of early reaction is carried out with ARVI, infectious mononucleosis, diphtheria, rubella, and other acute infections. If generalized lymphadenopathy is detected, it is necessary to exclude hyperthyroidism, brucellosis, viral hepatitis, syphilis, tularemia, amyloidosis, lupus erythematosus, rheumatoid arthritis, lymphoma, and other systemic and oncological diseases. According to indications, the patient is consulted by an infectious disease specialist, dermatologist, oncologist, endocrinologist, rheumatologist, hematologist.

Treatment of HIV infection in pregnant women

The main objectives of pregnancy management during infection with the human immunodeficiency virus are suppression of infection, correction of clinical manifestations, and prevention of infection of the child. Depending on the severity of symptoms and stage of the disease, massive polytropic therapy with antiretroviral drugs is prescribed - nucleoside and non-nucleoside reverse transcriptase inhibitors, protease inhibitors, integrase inhibitors. Recommended treatment regimens vary depending on different dates gestation:

• When planning a pregnancy. To avoid embryotoxic effects, women with HIV-positive status should stop taking special medications before the onset of a fertile ovulatory cycle. In this case, it is possible to completely eliminate the teratogenic effect in the early stages of embryogenesis.
• Up to 13 weeks of pregnancy. Antiretroviral drugs are used in the presence of secondary diseases, a viral load exceeding 100 thousand RNA copies/ml, and a decrease in the concentration of T-helper cells less than 100/μl. In other cases, it is recommended to stop pharmacotherapy to exclude negative effects on the fetus.
• From 13 to 28 weeks. When HIV infection is diagnosed in the second trimester or an infected patient is treated during this period, active retroviral therapy is urgently prescribed with a combination of three medicines- two nucleoside reverse transcriptase inhibitors and one drug from other groups.
• From 28 weeks until birth. Antiretroviral treatment continues, and chemoprophylaxis for transmission of the virus from woman to child is carried out. The most popular regimen is in which the pregnant woman constantly takes zidovudine from the beginning of the 28th week, and nevirapine once before giving birth. In some cases, backup schemes are used.

The preferred method of delivery for a pregnant woman diagnosed with HIV infection is natural birth. When performing them, it is necessary to exclude any manipulations that violate the integrity of tissues - amniotomy, episiotomy, application of obstetric forceps, use of a vacuum extractor. Due to a significant increase in the risk of infection of the child, the use of drugs that induce and enhance labor is prohibited. Caesarean section is performed after 38 weeks of gestation when the viral load is unknown, its level is more than 1,000 copies/ml, there is no prenatal antiretroviral therapy and the impossibility of administering retrovir during labor. IN postpartum period The patient continues to take recommended antiviral drugs. Because the breast-feeding child is prohibited, lactation is suppressed with medication.

Prognosis and prevention

Adequate prevention of HIV transmission from a pregnant woman to her fetus can reduce the rate of perinatal infection to 8% or less. In economically developed countries this figure does not exceed 1-2%. Primary prevention of infection involves the use of barrier contraceptives, sexual activity with a regular trusted partner, avoidance of injection drug use, the use of sterile instruments when performing invasive procedures, and careful monitoring of donor materials. To prevent infection of the fetus, timely registration of an HIV-infected pregnant woman with an antenatal clinic, refusal of invasive prenatal diagnostics, selection of the optimal antiretroviral treatment regimen and method of delivery, and prohibition of breastfeeding are important.

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Questions and answers on: HIV testing during pregnancy

2010-10-13 00:24:37

Julia asks:

Please, answer my question: the first HIV test during pregnancy was negative, my husband’s was negative, my last extramarital affair was more than four years ago... and the partner’s status is unknown... the question is this: second, third, fourth I took it for a medical examination once and the FA stubbornly shows positive.... Moreover, several of these times also hepatitis C is positive.... (the latter is really negative (this despite the fact that the PTS says that hepatitis C has been detected) What is it? Maybe Is it possible that if the FA shows positive three times in a row, it could be a reaction to a “foreign protein”, pregnancy? Or would it show differently?

Answers Silko Yaroslav Gennadievich:

PCR for hepatitis C indicates that the virus is present in the blood at the moment, although ELISA for hepatitis may be negative, since there are not enough antibodies or they have not yet been detected. The presence of a negative test for HIV, and then a positive one, may indicate that that you were infected during pregnancy or this is a false positive result (which is very rare during pregnancy). During pregnancy, you could only become infected through sexual contact, through drug use, or transfusion of infected blood. In any case, you need to contact the regional AIDS center, where they should take your HIV viral load (this will show whether there is a virus and its quantity). And my husband must repeat the HIV test now at the AIDS center and in a month (if the result is negative).

2014-04-04 11:19:27

Julia asks:

My husband and I took tests for HIV 3.5 years ago: when we came to get the result, I was negative, but they didn’t tell my husband the answer right away, but only 2 days later it turned out to be positive. He began to experience depression, binge drinking, etc. He refuses to take it again. And he is afraid to have a child. He is my doctor, he himself says that due to problems with the liver (he has some), there may be a positive result. What to do? Can I refuse to donate blood for HIV during pregnancy and when the baby is born?

Answers Gritsko Marta Igorevna:

Yes, you can refuse to take an HIV test. I would advise my husband to retake the test; it could be false positive. Was your husband in contact with HIV-infected people due to his occupation?

2015-12-01 07:40:38

Natalya asks:

Hello! I am 25 years old. In October 2014, the erosion was cauterized with a laser. To determine the cause, I took tests for hormones, torch, rubella, HIV, and a biopsy. Everything is okay. In May 2015 there was a miscarriage at 6 weeks. (I managed to get pregnant on the 4th cycle). After the miscarriage and cleansing, I took it for approx. 3 months. We're planning again. In August 2015, simple leukoplakia was diagnosed (biopsy confirmed). I tested for HPV type 21 - nothing was found. I took the torch test again - everything was clear. The doctor insists on treatment with proteflazid and mandatory cauterization with a laser before pregnancy. Another doctor says that the cervix should not be touched under any circumstances before pregnancy! There is a lot written on the Internet about how you can get pregnant and be monitored, and cauterized after childbirth. How do you see this situation? Should I cauterize the leukoplakia or wait until pregnancy and childbirth? If I cauterize, will there be any complications during pregnancy and childbirth? Is it worth taking proteflazid? (If HPV is negative). I really want to hear your opinion!!! Thank you

Answers Palyga Igor Evgenievich:

Hello, Natalia! One thing I can say for sure is that you don’t need proteflazid. What exactly are you going to treat with it? Leukoplakia? Taking this drug will definitely not make it go away. It is almost impossible to draw conclusions virtually regarding the condition of the cervix; it is necessary to see the picture and conclusion of colposcopy and biopsy. Theoretically, if histology confirms the presence of leukoplakia, then it is recommended to cauterize it before pregnancy. If the manipulation is adequately carried out, there should be no complications in the future; you are not being offered conization.

2015-01-28 12:36:20

Laura asks:

Why can you get a false positive result when testing a blood for HIV if a woman does not know that she is pregnant? How can blood tests be similar for pregnancy and HIV?

2014-12-16 17:40:15

Victoria asks:

Hello! Tell me, could the HIV test be incorrect if I took it during a year during pregnancy, I was in the hospital with the baby, and my husband tested for HIV a year later? He had no contacts on the side. Could his test be false positive? if he has a diseased liver.

Answers Sukhov Yuri Alexandrovich:

Hello, Victoria. Testing blood serum for HIV using ELISA is a preliminary procedure; this is the first stage of testing for HIV. Sincerely, YuSukhov.

2014-12-04 09:06:22

Tatiana asks:

Hello, this is the situation, I gave birth to a child, took tests during pregnancy like everyone else, and a year later I found out that my husband has been diagnosed with HIV for 6 years, tell me how can I and the child be healthy? I can't find a place for myself. Thank you

Answers Yanchenko Vitaly Igorevich:

Hello Tatiana! You need to undergo an anonymous examination at special HIV centers. You can find out about this by calling the helpline, which you can find on the Internet for your region. Good luck to you!

2014-10-15 07:11:58

Alina asks:

Hello, I took tests during pregnancy at 22 weeks, and here is the result, the doctor referred me to an infectious disease specialist without explaining what was wrong with me.... The blood is negative for HIV...
Bil-15.1
Glu-4.37
O, white - 80.0
Kreat-54
B;L-5.4
ALT-26
ACE-21
Urea-2.0
Creatinine-46.0
Glucose-4.62
Cholesterol-3.92
PTV-10.9
INR-1.00
fibrinogen-4.5
APTT-26.8
D-DIMER-266.00
Percentage of activity on Kwik - 109.0
Please tell me what's wrong with me????

Answers Zaitsev Igor Anatolievich:

Hello, Alina. The tests that I see are normal, so I think that the reason for the referral to an infectious disease specialist is some other reason. Ask your doctor or infectious disease specialist about this if you have already been there.

2014-09-07 18:27:00

Tanya asks:

Good evening! please tell me, my husband had HIV, he died in 2012... I didn’t know about the disease until it started to progress (I stopped taking pills), we didn’t use protection. we had a healthy daughter in 2010, he knew that there was a chance of getting pregnant and getting sick, but he didn’t use a condom, and I had no idea that he was sick! After his death, I took tests 8 times already... I’m still afraid of what might happen in me or my daughter...! Could it come out after some time on me or my child...?
I got married, maybe I have another child, can it come out during pregnancy?
Is there a chance that the unborn child will have it? can I give birth calmly and not worry that my current husband, daughter and our unborn child in safety?
What do i do?
Two days after birth, my daughter was tested for HIV - it was negative... (now I can’t understand whether my husband asked or whether it was necessary, I gave birth in a regular maternity hospital)!
thanks in advance for your answer

Answers Sukhov Yuri Alexandrovich:

Hello, Tanya. You actually have a lot of questions, but few concrete research results. There is no need to worry so much, you need to undergo a comprehensive examination. Taking into account the timing, with a probability of 99.9, after an appropriate examination, it is possible to clarify your condition and give recommendations. And also, keep in mind that chronic stress (like you have now!) reduces immunity! Contact us. Sincerely, Yu Sukhov.

2014-06-10 11:30:38

Sveta asks:

My period is 11 days late. The tests are negative. Upon examination, they say that the pregnancy is 5-6 weeks. Diagnoses trichomoniasis. Refers for tests for HIV, syphilis and cancer cells. What should I do? Get crazy. Help.

Answers Wild Nadezhda Ivanovna:

During pregnancy and when registering for pregnancy, these tests are taken twice, so I recommend calming down and donating blood tests for RV and HIV. A cytological examination of the smear, that is, a smear taken for “cancer cells,” is carried out in all women examined by a gynecologist. To confirm the presence of pregnancy, an ultrasound scan is necessary.

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Since the transmission of the human immunodeficiency virus occurs not only through sexual contact, but also through blood and breast milk, it is extremely necessary to be tested for HIV during pregnancy in order to prevent the possibility of transmitting the virus to the child. Decide for yourself whether to take this test or not, but remember that your decision largely determines whether your child will become infected.

HIV/AIDS is often asymptomatic, but the first signs of its manifestation may be swollen lymph nodes and pneumonia (pneumonia). Due to the absence of symptoms of the disease in most cases, a blood test is the only way identify it and begin timely treatment!

Blood test for antibodies to HIV/AIDS is carried out twice during pregnancy - the first blood donation is carried out upon registration, the second - at the 30th week of pregnancy. This need is due to the fact that the body needs about three months to produce antibodies (in case of infection). Therefore, when donating blood for the first time, you may have negative result, and in the second, antibodies can be detected.

According to statistics, every fourth HIV-infected woman who does not undergo appropriate therapy transmits the virus to the fetus. If the infection did not occur in utero, then without appropriate prevention it can happen during childbirth (through contact with blood and other biological fluids in the birth canal), as well as during breastfeeding. That is why HIV-infected mothers are offered childbirth by caesarean section and recommend refusing to feed the baby breast milk. It has been proven that cesarean section in combination with antiretroviral treatment reduces the risk of transmission of the virus to the child to less than 1%.

Children of mothers with HIV infection are born with antibodies to HIV/AIDS. These antibodies can disappear up to 18 months if the baby does not become infected with the human immunodeficiency virus during this time. Therefore, it is possible to say with confidence that a child is not sick with HIV only after a year and a half from the moment of his birth.

For blood analysis (test) for HIV/AIDS take blood from the ulnar vein. The analysis result will be ready within 10-14 days. If your result is negative (that is, no antibodies to HIV are detected), then you will receive the next referral for this test no earlier than the 30th week. But if your result is positive, you will have to donate blood again to confirm the diagnosis.

If the result is confirmed positive blood test for HIV-infection, a woman will have to undergo special examinations by an obstetrician-gynecologist and an infectious disease specialist. She will be offered treatment by taking antiretroviral drugs, the main purpose of which is to reduce the risk of infection of the fetus during pregnancy and childbirth. Immediately before childbirth (no matter what it will be - natural or by caesarean section), the woman is subjected to a course of intensive therapy (a complex of antibiotics and antiretroviral drugs).

In order to prevent the baby from developing HIV infection, immediately after birth he will also begin a course of antiretroviral therapy, which will continue for four to six weeks. Research conducted by domestic and foreign experts in this field confirms the safety of such treatment for a child. There has been no increase in the number of children with congenital developmental anomalies from the use of such drugs.

Every expectant mother undergoes a lot of different tests within 9 months, including testing for HIV infection. It is a real shock for a woman to receive a positive HIV result during pregnancy. Let's try to figure out why pregnant women can have a positive HIV result in the absence of HIV infection, and what to do if the test gives false results for HIV during pregnancy.

· A cruel joke, or a questionable HIV test during pregnancy

When, at a antenatal clinic, a doctor tells a pregnant woman that she has a positive HIV test, she’s ready to fall into hysterics. Intellectually, the expectant mother understands that this cannot happen, but panic inexorably clouds her eyes. And then there’s the doctor, at best, with sympathy, and at worst, with suspicion, looking at the unfortunate woman, writing her a referral to the AIDS center. In my head expectant mother Are thoughts swarming about that her life is over, every now and then, bumping into indignation over a misfortune that has come from nowhere? It seems like she’s not a prostitute, not a drug addict, a normal, decent woman... what will happen to the baby, what will happen to her, and how can she even tell her husband about such a thing? It’s good when the future dad is a completely adequate, reasonable person, but even his reaction is difficult to predict...

Much in this situation depends directly on the delicacy of the doctor and the woman’s awareness. Firstly, even really does not mean that it is actually in the blood. Any single HIV test, whether positive or negative, is questionable. To obtain reliable data, an HIV test must be taken several times. And of course, if a positive HIV result is obtained during pregnancy, you need to take additional tests (if the diagnosis is not confirmed, then this is a false positive result for HIV). And, secondly, false positive results for HIV in pregnant women occur quite often, due to reasons that are understandable from a medical point of view.

· Why does a false positive HIV test occur during pregnancy?

It turns out that false HIV results during pregnancy are a completely adequate reaction of the test to some processes that can occur in the body of a healthy pregnant woman. And to be more specific, then female body may in some cases produce antibodies to the developing fetus. The baby that develops in the mother’s womb is a fusion of two genetic materials, a woman and a man, and sometimes the female body can perceive this newly formed and growing DNA in it as foreign. And then the body’s defense mechanism begins to produce antibodies, which affects a positive HIV test during pregnancy.

Often, a false positive result for HIV during pregnancy occurs in women who have a history of some chronic disease.

In addition, false HIV results during pregnancy are also explained by the notorious “human factor” - no one has canceled it. Test tubes with blood could simply be mixed up, for example, or the results of a truly infected person could be included in your analysis.

As already mentioned, any HIV test done once, regardless of whether you are pregnant or not, is questionable. This is why an HIV test needs to be done several times, especially during pregnancy. In any case, a false positive test for HIV during pregnancy is better than a negative result in the presence of infection. But let's not talk about sad things.

· Consequences of a false positive result

Of course, doctors are aware that HIV tests in pregnant women are often false positive, but despite this, they are obliged to act in accordance with the recommendations of the Ministry of Health. In practice, this means that the pregnant woman needs to be tested again.

At the same time, specialists at the local AIDS center are unlikely to determine whether your HIV test is false or true. A medical card will be immediately issued indicating that you are being registered at the AIDS Center for the Fight and Prevention of AIDS. We hasten to reassure you that all your suffering will be limited to the usual blood test, so you should not react to the serious expression on the face of the lady at the reception, looking at you as if you were some kind of leper.

There is nothing to be done, such minor troubles are quite possible if a false positive result on an HIV test came in the first half of your pregnancy. Where big problems may arise if such a diagnosis is made to a woman immediately before childbirth.

If this happens, the pregnant woman is immediately isolated without waiting for the results of a repeat test. It would be a colossal stretch to call the situation in the maternity hospital healthy, since the likelihood that the staff will understand or even think about whether the expectant mother is really HIV-infected is zero. A woman will have to be patient and courageous to survive this time and the upcoming birth, until she receives “refuting” results. In addition, mothers will not be allowed to breastfeed their newborn, at least until a new, this time negative, result comes.

· What should a woman do if she receives a false positive result for HIV?

The first and most important thing a young mother needs to do when reporting her alleged positive test for HIV during pregnancy - breathe out and drive away panic! The Internet is crowded scary stories about women who have an abortion or jump off the roof of a 9-story building after receiving a questionable HIV test during pregnancy.

Of course, you cannot explain to everyone that such a test can give a false positive result; doctors themselves talk about the 50% accuracy of such an analysis, but sometimes behave, to put it mildly, incorrectly. Therefore, a young mother should show perseverance. You need to try to get through the next week as calmly as possible in this situation in order to wait for a repeat result. Time will pass, doubts will dissipate, and worries may affect your baby. Therefore, your main task is to remain calm and take care of your baby!

Yana Lagidna, especially for the site

And a little more about what affects a positive HIV test during pregnancy:

is a chronic viral disease that currently has no specific treatment. HIV infection affects the elements immune system, thereby increasing the body’s sensitivity to any infectious agents. With this disease, the patient suffers and ultimately dies precisely from secondary pathologies, which healthy person are tolerated quite easily and do not have critical health consequences.

AIDS is a relatively young disease. The presence of the immunodeficiency virus was first discovered only in 1981, when theories of the development of Kaposi's sarcoma and Pneumocystis pneumonia appeared. Until now, there is only maintenance antiretroviral therapy, which can reduce the body’s susceptibility to secondary infections and strengthen the immune status.

HIV testing of pregnant women has long been standard procedure. To date, the scientific community has made enormous progress in helping people with immunodeficiency: life expectancy has increased significantly, and its quality does not decrease significantly if therapy is prescribed in a timely manner. There are even high chances of giving birth healthy child from parents with such a diagnosis, but only under the strict supervision of medical personnel. Undoubtedly, the health of the unborn baby depends on the quality of the antiretroviral therapy administered and the stage of the mother’s disease. Therefore, pregnant women must be tested for HIV, several times during the gestation period. Blood for HIV testing during pregnancy is taken from a vein.

An important factor is social status mother, how the retrovirus was obtained and when (before or after conception). AIDS in pregnant women tends to progress rapidly due to changes in hormonal levels and the general load on all body systems. Also, bearing a child is often very difficult with such a diagnosis, since the body, due to being weakened by the virus, strives to get rid of the threatening condition. For these purposes, the woman is admitted to a hospital for examination. A long hospital stay is often required to save the baby. Is pregnant women tested for HIV in this case? Yes, without fail, since the result can be false positive, which is often noted during pregnancy.

HIV test during pregnancy

An HIV test during pregnancy is done at the antenatal clinic as prescribed by a gynecologist. How many times do they take an HIV (AIDS) test during pregnancy is a question that concerns many girls who are worried about the health of their unborn child. Usually the study is carried out twice. Should I get tested for HIV during pregnancy? In principle, such a question should not worry a woman, because the health of her unborn baby is at stake.

The timing of HIV testing in pregnant women depends on the type of test. A typical analysis takes up to about 2 days (this is determined by the level of workload of the laboratory - the more people pass through it, the longer you can expect the result). An express test for HIV during pregnancy is usually indicated in two cases:

• if the patient is admitted for emergency labor;
• at her request, but for a fee.

This is due to the very expensive materials for carrying out the rapid test. This analysis takes very little time - from 5 to 15 minutes.

It is advisable to regularly be examined for the presence of a retrovirus in the body, especially when planning conception, in order to avoid unpleasant surprises. An HIV test during menstruation can be taken in any laboratory, at this time the result will also be reliable, although after conception such a question does not arise for a woman.

Already pregnant women take an HIV test at the antenatal clinic. If a pregnant woman refuses to be tested for HIV, doctors may refuse to provide observation, and such a result will be completely legal. In such a case, information about a patient who refused to donate blood for antibodies to immunodeficiency will be transferred to special institutions, where a preventive conversation will be held with the woman, trying to convince her otherwise.

Do they do HIV testing in the maternity hospital? Such a study is not routinely prescribed. Testing is carried out only when indicated.

Sometimes it happens that during pregnancy the blood clots for HIV. Doctors cannot give an exact answer why this happens, but most often it is only due to poor-quality reagents during analysis. The cause may also be hormonal levels that change due to conception, or a blood clotting disorder, chronic diseases such as hypertension. If the biological material has coagulated, repeat the analysis with other reagents. In more than 70% of cases the problem is eliminated. However, if the situation repeats, additional blood tests are performed and a clinical and family history is collected more carefully.