The latest guidelines include information on combination anti-HIV therapy and pregnancy outcomes, protease inhibitor therapy and hyperglycemia, and mitochondrial toxicity and nucleoside analogue drugs. The guidelines also provide a new clinical scenario regarding recommendations for handling HIV-infected women in labor who have had no prior therapy. Until more information is known, it is recommended that women who already take combination anti-HIV therapy continue their regimen as prescribed during pregnancy. Careful and regular monitoring for complications and side effects is also advised. Hyperglycemia, an abnormally high level of blood sugar, is associated with protease inhibitor use.
Pregnancy is also a risk factor for hyperglycemia.
Concerns about this possibility have been added to the guidelines with a recommendation that doctors closely monitor glucose levels in pregnant women and discuss symptoms of hyperglycemia with their patients. Symptoms include high blood sugar, high levels of sugar in the urine, frequent urination, and increased thirst. Two of them died from severe neurological disease associated with mitochondrial damage. Evaluation to determine whether there is any evidence of mitochondrial damage in children in several large studies in the U.S. and Africa is ongoing. So far, no deaths have been reported that resemble those in the French study, and there is no evidence of associated neurological damage.