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BHIVA guidelines for the management of HIV in pregnancy and postpartum 2018 (2020 third interim update)

Introduction

The overall purpose of these guidelines is to provide guidance on best clinical practice in the treatment and management of women living with HIV in the UK during pregnancy and postpartum, 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 woman and her baby, 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 postpartum management of women has been added. Of note, the term ‘HIV’ refers to HIV-1 throughout these guidelines, unless HIV-2 is specified.

The purpose of a further 2020 interim review is to update significant developments that would either lead to a change in recommendation or a change in the strength of recommendation. These changes and the supporting evidence are highlighted. Additional information has been provided in areas of controversy.

BHIVA guidelines on the management of HIV in pregnancy and postpartum 2018


Downloads

BHIVA guidelines for the management of HIV in pregnancy and postpartum 2018 (2020 third interim update)

Additional information
Literature search strategies
Patient breastfeeding information leaflet 1
Patient breastfeeding information leaflet 2

Consultation comments
Download the comments received by the BHIVA Secretariat during the public consultation process

Declaration of interests
Download the declaration of interests from writing group members


Non-technical summary

View non-technical summary

Please note: The non-technical summary is less detailed than the full guideline and if you are reading this because it is relevant to your own healthcare, please do discuss any concerns or questions with your healthcare professionals.


Writing group

Dr Yvonne Gilleece (Chair), Dr Laura Byrne (Vice-chair), Dr Alasdair Bamford, Dr Sanjay Bhagani, Dr Emily Clarke, Ms Polly Clayden, Dr Hermione Lyall, Ms Janine Mcgregor-Read, Dr Rebecca Metcalfe, Dr Adrian Palfreeman, Ms Helen Peters, Ms Ana Maria Rodrigues de Oliveira, Dr Luciana Rubinstein, Ms Sonali Sonecha, Dr Shema Tariq, Dr Lisa Thorley, Dr Pat Tookey, Ms Jennifer Tosswill, Mr David Utting, Dr Steven Welch, Ms Alison Wright


Peer review

The guidelines were peer reviewed by Dr Karoline Aebi-Popp, University Hospital Bern, Switzerland, Dr Fiona Lyons, St. James’s Hospital, Dublin, Ireland, and Professor Graham Taylor, Imperial College London.


Guideline updates and date of next review

We aim to revise these guidelines by 2022. In the meantime, the writing group will confer at least annually to consider new information from high-quality studies and will issue revisions or updates should clinically important and relevant data become available.


Reference

Gilleece Y, Tariq S, Bamford A et al. British HIV Association guidelines for the management of HIV in pregnancy and postpartum 2018. HIV Med 2019; 20 Suppl 3: s2-s85.