ANTIRETROVIRAL THERAPY FOR PREGNANT-WOMEN

Reproductive-age women constitute an increasing percentage of individu als infected with human immunodeficiency virus. As clinical management issues particular to pregnancy become increasingly common, they are a lso becoming increasingly complex. With the approval of new antiretrov iral agents, monotherapy with zidovudine, although still standard for prevention of mother-to-child transmission of human immunodeficiency v irus, has become inadequate therapy for treatment of the mother. Clini cians must now consider alternative therapeutic strategies in spite of a dearth of experience in the setting of pregnancy. To facilitate opt imal drug treatment of human immunodeficiency virus-infected pregnant women while maintaining a focus on prevention of transmission, we revi ewed Medline, Reprotox, personal files, and pharmaceutical industry in formation about the antiretroviral agents currently approved. After su mmarizing potential beneficial and detrimental effects in both the pre gnant and nonpregnant individual, we suggest clinical strategies and d iscuss the ethical and legal principles that should guide therapeutic decisions in pregnancy.