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HIV in women.
Watts DH; U Of Washington, Seattle, WA.
November 30, 1996
3rd Conf Retro and Opportun Infect. 1996 Jan 28-Feb 1;:167. Unique

Women represent the most rapidly growing group of newly infected HIV-positive individuals in the U.S. and worldwide close to half of the HIV infections occur in women. The majority of HIV infected women are of reproductive age, thus, concomitant pregnancy and HIV infection are common. In addition, gynecologic conditions frequently cause morbidity in women. Zidovudine given antepartum, intrapartum, and to the neonate has been shown to reduce perinatal transmission from 25% to 8% among previously untreated women with CD4 counts above 200/cc. Other strategies being investigated to interrupt perinatal transmission include non-nucleoside reverse-transcriptase inhibitors, vaginal cleansing, and cesarean section. In general, pregnant women should receive prophylaxis and treatment as they would if not pregnant, but therapy must be individualized. Genital human papillomavirus infection and dysplasia are more common among HIV-positive compared to negative women, and the dysplasias are more likely to be high-grade, multifunctional, and recurrent among HIV-positive women. Recurrent genital herpes infections are frequent among HIV infected women. Aphthous ulcers may occur in the genital tract leading to rectovaginal and other fistulas. Pelvic inflammatory disease appears to require surgical treatment more often among HIV-positive women. HIV can be detected from the genital tract in approximately one third of seropositve women, but the relationship of HIV in the genital tract to gynecological complications has not been well studied. Contraceptive options will also be discussed. Complete care of the HIV-positive women must include complete gynecological assessment and care.

CD4 Lymphocyte Count Disease Transmission, Vertical Female Genital Diseases, Female/COMPLICATIONS HIV Infections/COMPLICATIONS/DRUG THERAPY/*EPIDEMIOLOGY/ TRANSMISSION Human Infant, Newborn Pregnancy Zidovudine/THERAPEUTIC USE ABSTRACT