MENNONITE COLLEGE of NURSING at ILLINOIS STATE UNIVERSITY

N317--HIV and Pregnancy Handout

WOMEN AT HIGHEST RISK FOR HIV INFECTION

1). Sexual partners of bisexually active males, hemophiliac, IV drug users, or known HIV + males 2). Past or current IV drug users 3). Women who received blood products form 1977-1985 4). Women with a history of STD’s or those at risk for STD’s from having multiple sex partners 5). Women with evidence of an HIV-related disease 6). Women from countries with a high rate of heterosexual transmission (e.g., Africa, Caribbean islands)

PRENATAL LABORATORY STUDIES

1). Antibodies to TORCH titer, syphilis, tuberculosis 2). CBC with differential and platelet count 3). Erythrocyte sedimentation rate (ESR) 4). Hepatitis B surface and cryptococcal antigens 5). SMA-12 6). Gonorrhea and chlamydia cultures 7). Pap smear 8). Chest X-ray (shielded abdomen) 9). CD4 Lymphocytes Absolute T4 lymphocyte count Percentage of T4 cells in total lymphocyte Ratio of T4 to T8 cells 10). Beta-2 macroglobulin

MONITOR LABORATORY RESULTS for patients receiving Antiretroviral drugs (Wissmann, J. (2007).Nursing care of children RN editions 7.0. ATI 1. Liver function studies a. SGPT (Serum glutamic pyruvic transaminase)  b. ALT (Alanine amino transferease) c. SGOT (Serum glutamic oxaloacetic transaminase)  d. AST (Aspartate aminotransferase)  e. Bilirubin  f. HDL (High density Lipoproteins)  g. Total cholesterol  h. Triglycerides  MENNONITE COLLEGE OF NURSING at ILLINOIS STATE UNIVERSITY

Antiretroviral Drugs and Pregnancy Risk

Nucleoside Reverse Transcriptase Inhibitors—interferes with the virus’s ability to convert RNA into DNA Generic Name Trade Name FDA Pregnancy Category *

Zidovudine (azt) Retrovir C

Didansone (ddi) Videx B

Zalcitabine (ddc) Hivid C

Stavudine (d4t) Zerit C

Lamivudine (3tc) Epivir C Nonnucleoside Reverse Transcriptase Inhibitors—inhibit viral replication in cells Generic Name Trade Name FDA Pregnancy Category *

Nevirapine Viramune C

Delaviridine Rescriptor C Protease Inhibitors—inhibits an enzyme needed for the virus to replicate Generic Name Trade Name FDA Pregnancy Category *

Indinavir Crixivan C

Ritonavir Norvir B

Saquinavir Inverase B

Nelfinavir Viracept B *FDA Pregnancy Categories:

A = adequate and well-controlled clinical studies in pregnant women show no evidence of risk to fetus during the first trimester of pregnancy.

B = Animal reproduction studies fail to demonstrate rusk to fetus, but there are no well- controlled studies on pregnant women.

C = Safety in human pregnancy has not been determined, so the drug should be used only if potential benefit outweighs potential risk to fetus.