THE WHOLE SUBJECT of human immunodeficiency virus (HIV) infection and pregnancy has alternately been a hotbed of discussion for those clinicians involved with HIV or ignored by the clinicians not involved. We are now only beginning to understand how HIV affects pregnancy.
How HIV affects pregnancy has been most dramatically revealed in the studies addressing transmission of HIV during pregnancy. This is not the purpose of this editorial as it has been dealt with elsewhere. However, 2 other things are clearly known: (1) there is a high fetal loss among HIV-positive mothers1; and (2) zidovudine (AZT) should be used during pregnancy to reduce the incidence of transmission.2 We now know maternal vitamin A deficiency contributes to the mother-child transmission of HIV. Nutritional augmentation of vitamin A in pregnant women with HIV probably makes sense.3
One of the ways a patient can become HIV positive is through substance