Menopause
ÎÎHormone replacement therapy (HRT), particularly if prolonged, has
been associated with a small increased risk of breast cancer and
cardiovascular and thromboembolic morbidity, and its routine use is
not currently recommended (A-I).
ÎÎHRT may be considered in women who experience severe menopausal
symptoms (eg, vasomotor symptoms, vaginal dryness) but should
generally be used only for a limited period of time and at the lowest
effective doses (B-II).
Mother-to-Child Transmission, Infants and Children
ÎÎPregnant women should be treated for HIV infection, regardless of
their immunologic or virologic status, to prevent infection of their
fetus (A-I).
ÎÎInfants exposed to HIV in utero should receive antiretroviral post
exposure prophylaxis and undergo HIV virologic diagnostic testing at
14-21 days of life, at 1-2 months of age, and at 4-6 months of age (A-II).
ÎAny positive virologic test should be repeated to confirm diagnosis (A-II).
Î
ÎHIV-infected infants should undergo HIV resistance testing (A-II) and,
Î
because of the rapid progression of disease, should initiate therapy in
the first year of life regardless of CD4 count, RNA or clinical status. (A-I).
ÎÎHIV-infected infants and children should be managed by a specialist
with knowledge of the unique therapeutic, pharmacologic, behavioral
and developmental issues associated with this disease (B-II).
Table 3. Centers for Disease Control and Prevention Scheme
for Defining Level of Immunosuppression in HIV-Infected
Children
CD4 Cell Count, Cells/mm3
(CD4 Cell Percentage), by Age
Category
0-12 months
1-5 years
> 6 years
Normal
> 1500 (> 25%)
> 1000 (> 25%)
> 500 (> 25%)
750-1499 (15%-24%)
500-999 (15%-24%)
200-499 (15%-24%)
< 750 (< 15%)
< 500 (< 15%)
< 200 (< 15%)
Moderate
Severe
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