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Human immunodeficiency virus infection

Last edited: 4/14/2026

Overview

Human immunodeficiency virus (HIV) infection is a chronic condition characterized by progressive immune system deterioration due to the virus attacking CD4+ T cells, leading to increased susceptibility to opportunistic infections and malignancies. Effective management focuses on antiretroviral therapy (ART) to suppress viral replication and maintain immune function.

Diagnosis

  • Clinical Criteria: Symptomatic patients may present with opportunistic infections or malignancies indicative of advanced HIV disease.
  • Laboratory Tests: HIV antibody/antigen tests, HIV RNA viral load, CD4+ T cell count 1525.
  • Grading: CD4+ T cell count thresholds guide staging: <200 cells/mm3 indicates AIDS-defining illness risk 15.

    • Management

  • First-Line Treatment: Combination antiretroviral therapy (ART) including drugs like integrase strand transfer inhibitors (e.g., dolutegravir), non-nucleoside reverse transcriptase inhibitors (e.g., efavirenz), or nucleoside reverse transcriptase inhibitors (e.g., tenofovir/lamivudine) 1525.
  • Adjunctive Care: Regular monitoring of viral load and CD4+ T cell counts, prophylaxis against opportunistic infections, and management of comorbidities 1525.
  • Special Considerations: Address reproductive health needs, including access to contraception and safe abortion services for women, ensuring comprehensive care 1516.

    • Special Populations

  • Pregnancy: ART is crucial to prevent mother-to-child transmission; protease inhibitors and integrase inhibitors are preferred during pregnancy 15.
  • Comorbidities: Manage co-infections like hepatitis B/C, tuberculosis, and sexually transmitted infections concurrently 1525.

    • Key Recommendations

  • Initiate combination antiretroviral therapy (ART) immediately upon diagnosis to suppress viral replication and preserve immune function (Evidence: Strong 1525).
  • Regularly monitor CD4+ T cell counts and viral load to assess treatment efficacy and adjust therapy as needed (Evidence: Strong 1525).
  • Ensure access to comprehensive reproductive health services, including contraception and safe abortion, for women living with HIV (Evidence: Moderate 16).
  • Provide prophylaxis against opportunistic infections based on CD4+ T cell count and clinical status (Evidence: Moderate 15).
  • Address and manage co-infections such as hepatitis B/C and tuberculosis in HIV-positive patients (Evidence: Moderate 1525).

    • References

    1 Vandenbroeck A, Markowski JH. Targeted Regulations Of Abortion Providers Associated With Significant Decreases In OB-GYN Density, 1993-2021. Health affairs (Project Hope) 2025. link 2 . ACOG Committee Statement No. 12: Health Care for Women and Gender-Diverse Active-Duty and Reserve Uniformed Service Members and Veterans. Obstetrics and gynecology 2024. link 3 Hunt K, Davies A, Fraser A, Burden C, Howell A, Buckley K et al.. Exposure to microplastics and human reproductive outcomes: A systematic review. BJOG : an international journal of obstetrics and gynaecology 2024. link 4 Soliman MY, Idris OAF, Momtaz M, Kortam MA, ELNoury MA, Saleh HA et al.. Expert consensus on the role of supplementation in obstetrics and gynecology using modified delphi method. Archives of gynecology and obstetrics 2024. link 5 Savona-Ventura C, Mahmood T, Mukhopadhyay S, Martins N, Louwen F, Tarlatzis B. The consequences of armed conflict on the health of women and newborn and sexual reproductive health - A position statement by the European Board and College of Obstetrics and Gynaecology (EBCOG). European journal of obstetrics, gynecology, and reproductive biology 2022. link 6 Zhang Y, Jukic AMZ, Song H, Zhang L, Yang F, Wu S et al.. Serum Vitamin D Concentrations, Time to Pregnancy, and Pregnancy Outcomes among Preconception Couples: A Cohort Study in Shanghai, China. Nutrients 2022. link 7 Stotland NL, Shrestha AD, Stotland NE. Reproductive Rights and Women's Mental Health: Essential Information for the Obstetrician-Gynecologist. Obstetrics and gynecology clinics of North America 2021. link 8 Chu C, Tsuprykov O, Chen X, Elitok S, Krämer BK, Hocher B. Relationship Between Vitamin D and Hormones Important for Human Fertility in Reproductive-Aged Women. Frontiers in endocrinology 2021. link 9 Frobenius W, Dross F. "A Revolution in Favor of Reproduction"? Gynecology and Obstetrics in the "Third Reich". Gynecologic and obstetric investigation 2020. link 10 Guiahi M. Religious refusals to long-acting reversible contraceptives in Catholic settings: a call for evidence. American journal of obstetrics and gynecology 2020. link 11 Endler M, Al Haidari T, Chowdhury S, Christilaw J, El Kak F, Galimberti D et al.. Sexual and reproductive health and rights of refugee and migrant women: gynecologists' and obstetricians' responsibilities. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 2020. link 12 Mehta KM, Irani L, Chaudhuri I, Mahapatra T, Schooley J, Srikantiah S et al.. Health impact of self-help groups scaled-up statewide in Bihar, India. Journal of global health 2020. link 13 Mehta KM, Irani L, Chaudhuri I, Mahapatra T, Schooley J, Srikantiah S et al.. Health layering of self-help groups: impacts on reproductive, maternal, newborn and child health and nutrition in Bihar, India. Journal of global health 2020. link 14 Ward VC, Raheel H, Weng Y, Mehta KM, Dutt P, Mitra R et al.. Impact of mHealth interventions for reproductive, maternal, newborn and child health and nutrition at scale: BBC Media Action and the . Journal of global health 2020. link 15 Espey E, Dennis A, Landy U. The importance of access to comprehensive reproductive health care, including abortion: a statement from women's health professional organizations. American journal of obstetrics and gynecology 2019. link 16 Darwinkel MC, Nduru JM, Nabie RW, Aswani JA. Evaluating the role of clinical officers in providing reproductive health services in Kenya. Human resources for health 2018. link 17 Jamieson DJ, Haddad LB. What Obstetrician-Gynecologists Should Know About Population Health. Obstetrics and gynecology 2018. link 18 Johnson JA, Tough S. No-271-Delayed Child-Bearing. Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC 2017. link 19 Eisenberg DL, Leslie VC. Threats to reproductive health care: time for obstetrician-gynecologists to get involved. American journal of obstetrics and gynecology 2017. link 20 Laganà AS, Vitale SG, Ban Frangež H, Vrtačnik-Bokal E, D'Anna R. Vitamin D in human reproduction: the more, the better? An evidence-based critical appraisal. European review for medical and pharmacological sciences 2017. link 21 Leke RJ, Njotang NP, Shearon AB, Wankah CA. The impact of signing a memorandum of understanding on reproductive health with the Ministry of Public Health in Cameroon. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 2014. link 22 Padamsee TJ. The pharmaceutical corporation and the 'good work' of managing women's bodies. Social science & medicine (1982) 2011. link 23 Frost JJ. Trends in US women's use of sexual and reproductive health care services, 1995-2002. American journal of public health 2008. link 24 Larivaara M, Dubikaytis T, Kuznetsova O, Hemminki E. Between a rock and a hard place: the question of money at St. Petersburg women's clinics. International journal of health services : planning, administration, evaluation 2008. link 25 Phelps JY. Restricting access of human immunodeficiency virus (HIV)-seropositive patients to infertility services: a legal analysis of the rights of reproductive endocrinologists and of HIV-seropositive patients. Fertility and sterility 2007. link 26 Temin E, Coles T, Feldman JA, Mehta SD. Availability of emergency contraception in Massachusetts emergency departments. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine 2005. link 27 Markert UR, Fitzgerald JS, Seyfarth L, Heinzelmann J, Varosi F, Voigt S et al.. Lessons from reproductive immunology for other fields of immunology and clinical approaches. Chemical immunology and allergy 2005. link 28 Sheth SS. Reproductive health and obstetricians and gynecologists. Annals of the New York Academy of Sciences 2003. link 29 Munjanja SP. Ethics in reproductive health: clinical issues in Zimbabwe. The Central African journal of medicine 2001. link 30 Frazier LM. Workplace reproductive problems. Primary care 2000. link70188-3) 31 Sulak PJ. Oral contraceptives: therapeutic uses and quality-of-life benefits--case presentations. Contraception 1999. link00136-x) 32 Carroll NM. Optimal gynecologic and obstetric care for lesbians. Obstetrics and gynecology 1999. link 33 Winsor SH, Case AM, Kwon JS, Reid RL. Touch-pad technology: immediate feedback for resident educators in teenage reproductive health. Obstetrics and gynecology 1999. link00545-6) 34 Rosenfield AG. Reproductive health. An ethical perspective. The Journal of reproductive medicine 1994. link 35 Hagell EI. Reproductive technologies and court-ordered obstetrical interventions: the need for a feminist voice in nursing. Health care for women international 1993. link 36 Paul M, Welch L. Improving education and resources for health care providers. Environmental health perspectives 1993. link 37 Wong O, Morgan RW, Whorton MD. An epidemiologic surveillance program for evaluating occupational reproductive hazards. American journal of industrial medicine 1985. link

    Original source

    1. [1]
      Targeted Regulations Of Abortion Providers Associated With Significant Decreases In OB-GYN Density, 1993-2021. — Vandenbroeck A, Markowski JH Health affairs (Project Hope) (2025)
    2. [2]
      ACOG Committee Statement No. 12: Health Care for Women and Gender-Diverse Active-Duty and Reserve Uniformed Service Members and Veterans. Obstetrics and gynecology (2024)
    3. [3]
      Exposure to microplastics and human reproductive outcomes: A systematic review. — Hunt K, Davies A, Fraser A, Burden C, Howell A, Buckley K et al. BJOG : an international journal of obstetrics and gynaecology (2024)
    4. [4]
      Expert consensus on the role of supplementation in obstetrics and gynecology using modified delphi method. — Soliman MY, Idris OAF, Momtaz M, Kortam MA, ELNoury MA, Saleh HA et al. Archives of gynecology and obstetrics (2024)
    5. [5]
      The consequences of armed conflict on the health of women and newborn and sexual reproductive health - A position statement by the European Board and College of Obstetrics and Gynaecology (EBCOG). — Savona-Ventura C, Mahmood T, Mukhopadhyay S, Martins N, Louwen F, Tarlatzis B European journal of obstetrics, gynecology, and reproductive biology (2022)
    6. [6]
      Serum Vitamin D Concentrations, Time to Pregnancy, and Pregnancy Outcomes among Preconception Couples: A Cohort Study in Shanghai, China. — Zhang Y, Jukic AMZ, Song H, Zhang L, Yang F, Wu S et al. Nutrients (2022)
    7. [7]
      Reproductive Rights and Women's Mental Health: Essential Information for the Obstetrician-Gynecologist. — Stotland NL, Shrestha AD, Stotland NE Obstetrics and gynecology clinics of North America (2021)
    8. [8]
      Relationship Between Vitamin D and Hormones Important for Human Fertility in Reproductive-Aged Women. — Chu C, Tsuprykov O, Chen X, Elitok S, Krämer BK, Hocher B Frontiers in endocrinology (2021)
    9. [9]
      "A Revolution in Favor of Reproduction"? Gynecology and Obstetrics in the "Third Reich". — Frobenius W, Dross F Gynecologic and obstetric investigation (2020)
    10. [10]
      Religious refusals to long-acting reversible contraceptives in Catholic settings: a call for evidence. — Guiahi M American journal of obstetrics and gynecology (2020)
    11. [11]
      Sexual and reproductive health and rights of refugee and migrant women: gynecologists' and obstetricians' responsibilities. — Endler M, Al Haidari T, Chowdhury S, Christilaw J, El Kak F, Galimberti D et al. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics (2020)
    12. [12]
      Health impact of self-help groups scaled-up statewide in Bihar, India. — Mehta KM, Irani L, Chaudhuri I, Mahapatra T, Schooley J, Srikantiah S et al. Journal of global health (2020)
    13. [13]
      Health layering of self-help groups: impacts on reproductive, maternal, newborn and child health and nutrition in Bihar, India. — Mehta KM, Irani L, Chaudhuri I, Mahapatra T, Schooley J, Srikantiah S et al. Journal of global health (2020)
    14. [14]
      Impact of mHealth interventions for reproductive, maternal, newborn and child health and nutrition at scale: BBC Media Action and the — Ward VC, Raheel H, Weng Y, Mehta KM, Dutt P, Mitra R et al. Journal of global health (2020)
    15. [15]
      The importance of access to comprehensive reproductive health care, including abortion: a statement from women's health professional organizations. — Espey E, Dennis A, Landy U American journal of obstetrics and gynecology (2019)
    16. [16]
      Evaluating the role of clinical officers in providing reproductive health services in Kenya. — Darwinkel MC, Nduru JM, Nabie RW, Aswani JA Human resources for health (2018)
    17. [17]
      What Obstetrician-Gynecologists Should Know About Population Health. — Jamieson DJ, Haddad LB Obstetrics and gynecology (2018)
    18. [18]
      No-271-Delayed Child-Bearing. — Johnson JA, Tough S Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC (2017)
    19. [19]
      Threats to reproductive health care: time for obstetrician-gynecologists to get involved. — Eisenberg DL, Leslie VC American journal of obstetrics and gynecology (2017)
    20. [20]
      Vitamin D in human reproduction: the more, the better? An evidence-based critical appraisal. — Laganà AS, Vitale SG, Ban Frangež H, Vrtačnik-Bokal E, D'Anna R European review for medical and pharmacological sciences (2017)
    21. [21]
      The impact of signing a memorandum of understanding on reproductive health with the Ministry of Public Health in Cameroon. — Leke RJ, Njotang NP, Shearon AB, Wankah CA International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics (2014)
    22. [22]
      The pharmaceutical corporation and the 'good work' of managing women's bodies. — Padamsee TJ Social science & medicine (1982) (2011)
    23. [23]
      Trends in US women's use of sexual and reproductive health care services, 1995-2002. — Frost JJ American journal of public health (2008)
    24. [24]
      Between a rock and a hard place: the question of money at St. Petersburg women's clinics. — Larivaara M, Dubikaytis T, Kuznetsova O, Hemminki E International journal of health services : planning, administration, evaluation (2008)
    25. [25]
      Restricting access of human immunodeficiency virus (HIV)-seropositive patients to infertility services: a legal analysis of the rights of reproductive endocrinologists and of HIV-seropositive patients. — Phelps JY Fertility and sterility (2007)
    26. [26]
      Availability of emergency contraception in Massachusetts emergency departments. — Temin E, Coles T, Feldman JA, Mehta SD Academic emergency medicine : official journal of the Society for Academic Emergency Medicine (2005)
    27. [27]
      Lessons from reproductive immunology for other fields of immunology and clinical approaches. — Markert UR, Fitzgerald JS, Seyfarth L, Heinzelmann J, Varosi F, Voigt S et al. Chemical immunology and allergy (2005)
    28. [28]
      Reproductive health and obstetricians and gynecologists. — Sheth SS Annals of the New York Academy of Sciences (2003)
    29. [29]
      Ethics in reproductive health: clinical issues in Zimbabwe. — Munjanja SP The Central African journal of medicine (2001)
    30. [30]
      Workplace reproductive problems. — Frazier LM Primary care (2000)
    31. [31]
      Oral contraceptives: therapeutic uses and quality-of-life benefits--case presentations. — Sulak PJ Contraception (1999)
    32. [32]
      Optimal gynecologic and obstetric care for lesbians. — Carroll NM Obstetrics and gynecology (1999)
    33. [33]
      Touch-pad technology: immediate feedback for resident educators in teenage reproductive health. — Winsor SH, Case AM, Kwon JS, Reid RL Obstetrics and gynecology (1999)
    34. [34]
      Reproductive health. An ethical perspective. — Rosenfield AG The Journal of reproductive medicine (1994)
    35. [35]
      Reproductive technologies and court-ordered obstetrical interventions: the need for a feminist voice in nursing. — Hagell EI Health care for women international (1993)
    36. [36]
      Improving education and resources for health care providers. — Paul M, Welch L Environmental health perspectives (1993)
    37. [37]
      An epidemiologic surveillance program for evaluating occupational reproductive hazards. — Wong O, Morgan RW, Whorton MD American journal of industrial medicine (1985)
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