INFEKCIJA VIRUSOM HUMANE IMUNODEFICIJENCIJE U TRUDNOĆI

Radmila M. Sparić; Aleksandra Pavić; Luka Andrić; Aleksa Novković; Đina Tomašević; Slađana Pavić

doi:10.5937/smclk4-42665

Radmila M. Sparić Klinika za ginekologiju i akušersvo, Klinički centar SrbijeMedicinski fakultet, Univerzitet u Beogradu https://orcid.org/0000-0003-0515-1951
Aleksandra Pavić Univerzitetski klinički centar Srbije
Luka Andrić Klinika za ginekologiju i akušerstvo Univerzitetski klinički centar Srbije
Aleksa Novković Univerzitetski klinički centar Srbije
Đina Tomašević Odeljenje opšte i dečije hirurgije Opšta bolnica Čačak
Slađana Pavić Odeljenje infektivnih i tropskih bolesti Opšta bolnica Užice

DOI: https://doi.org/10.5937/smclk4-42665

Ključne reči: trudnoća, porođaj, HIV

Sažetak

HIV infekcija predstavlja jedan od najvećih globalnih izazova javnog zdravlja, posebno kod žena u reproduktivnom periodu. U 2020. godini, u svetu je bilo 1,3 miliona trudnica sa HIV-om. Nelečena HIV infekcija u trudnoći nosi povećani rizik od maternalnog i perinatalnog morbiditeta i mortaliteta. Perinatalna transmisija HIV-a podrazumeva prenos virusa sa majke na dete tokom trudnoće, porođaja, ili tokom dojenja. Cilj ovog rada je prikaz najnovijih informacija o dijagnostici, lečenju i praćenju trudnoće kod trudnica pozitivnih na HIV, uz osvrt na vreme i način završavanja trudnoće radi prevencije transmisije virusa sa majke na fetus.

Osnovni ciljevi praćenja i lečenja HIV infekcije u trudnoći su: prevencija prenosa virusa na fetus, očuvanje zdravlja majke i stvaranje uslova za bezbedan porođaj. Cilj terapije je da održi najmanji nivo virusa u krvi, posebno u vreme porođaja, kako bi se smanjio rizik od vertikalnog prenosa.

Preporučljivo je započeti lečenje HIV infekcije pre trudnoće. Takođe, neophodna je redovna kontrola serumskog nivoa virusa, broja CD4+ limfocita, krvne slike, kao i obavljanje testova funkcije jetre i bubrega.

Izbor vremena i načina završavanja trudnoće ne bi trebalo da se razlikuje kod trudnica sa niskim nivoom virusa u serumu u odnosu na zdrave trudnice, dok kod trudnica sa visokim nivoom virusa, trudnoću treba završiti elektivnim carskim rezom.

HIV infekcija utiče i na trudnicu i na fetus, te je važno antenatalno, intrapartalno i postporođajno praćenje. Odluka o terapiji, kao i o vremenu i načinu porođaja, treba da bude individualna, a donosi se u skladu sa serumskim nivoom virusa, kliničkom slikom HIV infekcije majke i stanjem fetusa.

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