HIV Infection in Pregnant Women: A 2020 Update

Acquired immunodeficiency syndrome (AIDS) was first described in 1981, and continues to be one of the worst global health pandemics in recorded history. Concerted international efforts have helped to increase awareness of human immunodeficiency (HIV) status, improve access to treatment and continuation of therapy to achieve viral suppression with a goal of ending the AIDS epidemic by 2030. The clinical outcomes for patients living with HIV on combined antiretroviral therapy are considerably improved with prolonged life expectancy and superior quality of life. Further, perinatal transmission rates have dramatically decreased with elimination of mother to child transmission of HIV in a growing number of countries worldwide. However, there have been significant reductions in the pace of progress in treatment expansion for pregnant women with failure to meet global targets in 2018. In this review, we will highlight recent advances and challenges ahead in 2020 for three areas of perinatal care for women with HIV in developed countries: (a) pregnancy planning considerations, (b) impact of antiviral medications on perinatal outcomes, and (c) infant feeding practices. The promise of a HIV-free generation is on the horizon and continued international efforts in preventing perinatal transmission are an important component of this achievement.