Case 4

A 26 year-old woman with known HIV infection is admitted at 39 weeks gestation in active labor. She was initially diagnosed as having HIV infection by her obstetrician at her first prenatal visit at 16 weeks’ gestation when she admitted that she had used intravenous drugs in the past. She did not return for follow up visits. Her pregnancy has been otherwise unremarkable. She has been on no medications. Her infant weighted 3400 g. and had APGARS of 9 at one minute and 10 at 5 minutes. He was a vigorous baby and the physical examination was entirely normal.

Questions

1. What is the likelihood that the infant acquired HIV infection from his mother?

2. How is the virus transmitted from mother to infant?

3. What is known about the pathogenesis of the infection in the fetus infant?

4. what are the abnormalities of the immune system?

5. How is the viral infection detected in the infant?

6. Is prevention from mother to infant possible?

7. What are the long-term consequences of the infection in the infant?