**3.3. Medical examinations and specialty consultations that should be ordered in HIV(+) pregnant women**

Every patient with confirmed serology should be referred to consultation, and immediate coordination should be implemented in order to provide the patient with assessment by a multidisciplinary team (Grade D recommendation).

Routine exams different from those performed on the nonpregnant HIV-positive women are not justified in the pregnant patient with recent positive serology, with the exception of those clinically warranted (Grade D recommendation).

Other STDs should be actively ruled out. Hepatitis B and hepatitis C serology as well as tuberculin skin testing (PPD) should also be performed (Grade D recommendation). Lym‐ phocyte count, viral load, and viral genotyping should be ordered by the immunologist or the infectologist (Grade D recommendation).

The following are listed laboratory tests that should be routinely carried out [2]:


#### **3.4. Immunological parameters**

#### *3.4.1. CD4 T-cell count and viral load assessment (PCR)*

These are prognostic factors for vertical transmission, and they are determinant factors for the appropriate time to initiate ART. They are also parameters for the assessment of the therapeutic response.

#### *3.4.2. Genotyping*

Its evaluation is critical to assess resistance to antiretroviral therapy.

This information indicates that HIV(+) pregnant women should be assessed and treated by a multidisciplinary medical team (Infectologist, immunologist, pharmacist, obstetrician, and neonatologist) (Level 4 evidence) [16-21]. Additionally, as previously mentioned, screening for various STDs found to be related with increased VT is of key importance. Such screening should include herpes simplex virus 2 and *T. pallidum* (Level 2+ evidence [2-9].
