1. Scope and purpose
The overall purpose of these guidelines is to provide guidance on best clinical practice in the treatment and management of pregnant women living with HIV (human immunodeficiency virus) in the UK and their infants. The scope includes guidance on the use of antiretroviral therapy (ART) both to prevent vertical transmission of HIV and for the welfare of the mother herself, guidance on mode of delivery and recommendations in specific patient populations where other factors need to be taken into consideration, such as co-infection with other agents. The guidelines are aimed at clinical professionals directly involved with, and responsible for, the care of pregnant women living with HIV. The 2018 guidelines have identified significant developments that have either led to a change in recommendation or a change in the strength of recommendation. More detail has been added in areas of controversy, particularly breastfeeding. New data that simply support the existing data have not routinely been included in this revision. A new section on the postnatal management of women has been added.
process as both important and essential. The Writing Group included a patient representative who was involved in all aspects of the guideline development.
• Publication in HIV Medicine
• Shortened version detailing concise summary of recommendations
• E-learning module accredited for CME
• Educational slide set to support local and regional educational meetings
• National BHIVA audit programme
• We have expanded the section on 'The psychosocial care of women living with HIV during and after pregnancy' and moved its position within the guidelines.
• Safety: new data on raltegravir, rilpivirine, dolutegravir, elvitegravir.
• Prescribing: all women are recommended to start on treatment and remain on it lifelong. As this includes elite controllers this section has been removed.
• Hepatitis: information added on tenofovir alafenamide for hepatitis B and direct acting agents for hepatitis C.
• We have added a section on the postnatal management of women living with HIV.
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