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Titolo:
Diagnostics and treatment of HIV-discordant couples who wish to have children
Autore:
Weigel, MM; Kremer, H; Sonnenberg-Schwan, U; Golz, J; Gurtler, L; Doerr, HW; Brockmeyer, NH;
Indirizzi:
Univ Mannheim, Frauenklin, D-68167 Mannheim, Germany Univ Mannheim Mannheim Germany D-68167 enklin, D-68167 Mannheim, Germany All AIDS EV, Dortmund, Germany All AIDS EV Dortmund GermanyAll AIDS EV, Dortmund, Germany KIS, Munich, Germany KIS Munich GermanyKIS, Munich, Germany Praxiszentrum Kaiserdamm, Berlin, Germany Praxiszentrum Kaiserdamm Berlin Germany rum Kaiserdamm, Berlin, Germany Univ Greifswald, Inst Med Mikrobiol, Greifswald, Germany Univ Greifswald Greifswald Germany t Med Mikrobiol, Greifswald, Germany Univ Frankfurt Kliniken, Inst Med Virol, Frankfurt, Germany Univ FrankfurtKliniken Frankfurt Germany Med Virol, Frankfurt, Germany Ruhr Univ Bochum, St Josef Hosp, Dermatol Klin, D-4630 Bochum, Germany Ruhr Univ Bochum Bochum Germany D-4630 atol Klin, D-4630 Bochum, Germany
Titolo Testata:
EUROPEAN JOURNAL OF MEDICAL RESEARCH
fascicolo: 7, volume: 6, anno: 2001,
pagine: 317 - 321
SICI:
0949-2321(20010730)6:7<317:DATOHC>2.0.ZU;2-Y
Fonte:
ISI
Lingua:
ENG
Soggetto:
IMMUNODEFICIENCY-VIRUS TYPE-1; PERINATAL TRANSMISSION; ZIDOVUDINE; WOMEN; RISK;
Keywords:
assisted reproduction; HIV discordant couples; HIV prevention; reproductive counseling; semen preparation;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
15
Recensione:
Indirizzi per estratti:
Indirizzo: Weigel, MM Univ Mannheim, Frauenklin, D-68167 Mannheim, Germany Univ Mannheim Mannheim Germany D-68167 8167 Mannheim, Germany
Citazione:
M.M. Weigel et al., "Diagnostics and treatment of HIV-discordant couples who wish to have children", EUR J MED R, 6(7), 2001, pp. 317-321

Abstract

Over the last years the reality surrounding HIV-infection has undergone a considerable change with regard to the life expectancy of patients, and theplans they can make for their lives. Because the majority of the HIV positive population is of reproductive age, one of these plans might be to have children, often as an expression of a fulfilled partnership. The need for medical support to realize this wish, however, is often confronted with ethical, medical or forensic restraints. For this reason, interdisciplinary recommendations have now been developed -for the first time on a global basis - which aim to provide guidelines for practitioners in this complicated area. Care and support of HIV-positive individuals who desire children is an interdisciplinary task. If the occasion should arise, non-medical psycho-social measures also have to be integrated. Factors to be considered in couple counseling include disease progression, early and comprehensive infection diagnostics, and fertility screening for both partners. All steps of diagnostics and treatment have to be documented completely, and written documentation must be obtained from the affected individuals stating that they clearlyunderstand the remaining risk of infection for the healthy partner and even the child. If one of the partners is not compliant or has an advanced stage of HIV-disease (CDC B3 or C), active reproductive support should not be provided. HIV-positive women should be informed about the possibility of self-insemination so that the healthy partner is protected from HIV-infection. Medicalmeasures taken to reestablish fertility or optimize conception are acceptable as long as polyovulations are prevented. However, there are forensic reservations with respect to assisted reproduction techniques due to the remaining risk of materno-fetal transmission which under optimized conditions is low, but still quantifiable. Wherever the male partner is HIV-infected, infectious viral particles can be separated from motile spermatozoa by density gradient centrifugation andsubsequent swim-up. To exclude the possibility of viral contamination to the greatest degree of certainty, one aliquot from each prepared sample should be tested for HIV nucleic acid using highly sensitive detection methods. As a rule, this requires cryo-preservation. Processed, tested sperm samples can then be used for all techniques of assisted reproduction in the healthy female partner.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 09/04/20 alle ore 10:51:56