HIV and Reproductive Desire: How to Plan a Safe Pregnancy?



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Advances in HIV prevention, diagnosis and treatment have improved the quality and life expectancy of infected patients, and since many patients are diagnosed at reproductive age and have a desire to be parents, There are different strategies to prevent infection to your partner and the offspring.

In that sense, Carolina Tomatis, coordinator of the HIV and infertility program of the Halitus Medical Institute and Florencia Cahn Médica Infectóloga, deputy director of the Medical Center Guest, explained that "in 2014 the CDC (Center of Disease Control) approved the use of pre-exposure prophylaxis with a drug called Truvada (Tenofovir / emtricitabine) that prevents infection in 90%. "

"Treatment consists of taking this medication on a daily basis and practicing unprotected sex (condom) at the fertile moment of the female cycle. In December 2017, the CDC and the HHS endorsed the search for unprotected pregnancies or prophylaxis with Truvada, since current high-throughput antiretroviral therapy effectively achieves an undetectable viral load and stable, "said Tomatis. and Cahn.

According to experts, "this stems from the concept that the person with undetectable viral load for more than 6 months, does not transmit the virus"For this, adherence to strict treatment and control through frequent viral loads and testing for other sexually transmitted diseases that may increase susceptibility to infection are very important," they noted.

HIV experts have commented that although these recommendations are being applied by the scientific community in many European countries, as well as by infectious diseases in Argentina, "there are still patients who do not accept taking risks and continue to use fertility centers where they can have access." to the special processing of the semen sample that makes it safe not to transmit the infection. "

"When the partner with positive serology is male, despite having an undetectable viral load in the blood, it is estimated that 3 to 8% may have HIV positive viral load in semen, and therefore avoid minimal risk of infection, in our center we suggest performing intrauterine insemination or high complexity in vitro with a special semen processing that involves washing and subsequent negative viral load for the HIV virus, eliminating any possibility of transmission, "they said.

Tomatis and Cahn stated that "if the woman is infected, she can self-inseminate with her partner's semen or, if necessary, in vitro. In case both members are infected, Halitus is also suggested to wash the semen to avoid superinfection by another HIV serotype. "

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