A case report of a healthy newborn naturally born to HIV-positive parents

Abstract

AIM: It's crucial to test pregnant women for HIV and, if needed, start treatment promptly to reduce the risk of mother-to-child transmission. This case report aims to advocate for a change in practice at the Clinical Center of the University of Sarajevo. BACKGROUND: Transmission of the human immunodeficiency virus (HIV) from an untreated mother is the primary cause of HIV infection in newborns. CASE PRESENTATION: A 39-year-old woman consulted an infectious disease specialist after finding out she was six weeks pregnant, and her partner was HIV positive but not adherent to therapy. Despite her worries, her physical exam showed normal results. HIV tests confirmed she was HIV positive, with a viral load of 131 000 cp/ml. The next day, the patient started taking a combination of tenofovir/emtricitabine and raltegravir. Within a month, the treatment effectively lowered the viral load to an undetectable level. The initial CD4 cell count was 200 per mm3 of blood and gradually increased with continued therapy. OUTCOME: The pregnancy went well with regular check-ups. Although a cesarean section was planned, the baby was born naturally three days before the due date. After birth, the baby girl received prophylaxis with zidovudine for six weeks. The baby has been confirmed to be in good health and HIV-negative through multiple HIV tests following the established protocols. CONCLUSION: In Bosnia and Herzegovina, pregnant women are not routinely tested for HIV. HIV testing during pregnancy is simple, inexpensive, and can significantly improve the health of both the mother and the newborn.

Keywords

• HIV testing
• pregnancy
• mother-to-child transmission