title: Trends in human immunodeficiency virus (HIV) counseling, testing, and antiretroviral treatment of HIV-infected women and perinatal transmission in North Carolina.
abstract: Since 1993, trends in perinatal human immunodeficiency virus (HIV) transmission have been monitored by use of chart review of patients identified at a central diagnostic laboratory. In the population studied, either pre- or postnatal antiretroviral therapy to the infant increased from 21% in 1993 to 95% in 1997. Concurrently, the number of HIV-infected infants declined from 25 in 1993 to 4 in 1997. The complete Pediatric AIDS Clinical Trials Group Protocol 076 regimen was the most effective in reducing transmission (3.1%). Twenty-two of 35 infants who became infected in 1995-1997 had mothers who did not receive antiretroviral therapy, although counseling practices improved with time. In 1995, 87% of the mothers of HIV-seropositive infants were counseled, whereas in 1997, 96% were counseled (P<.005). None of 59 infants tested had high-level phenotypic zidovudine resistance, although 5 (8.8%) of 57 infants had virus isolates with at least one mutation in the reverse transcriptase gene associated with reduced phenotypic susceptibility to zidovudine.
authors.affiliation: Department of Microbiology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC 27599-7140, USA. sfiscus@email.unc.edu
authors.forename: S A
authors.initials: SA
authors.lastname: Fiscus
authors.forename: A A
authors.initials: AA
authors.lastname: Adimora
authors.forename: V J
authors.initials: VJ
authors.lastname: Schoenbach
authors.forename: R
authors.initials: R
authors.lastname: McKinney
authors.forename: W
authors.initials: W
authors.lastname: Lim
authors.forename: D
authors.initials: D
authors.lastname: Rupar
authors.forename: J
authors.initials: J
authors.lastname: Kenny
authors.forename: C
authors.initials: C
authors.lastname: Woods
authors.forename: C
authors.initials: C
authors.lastname: Wilfert
authors.forename: V A
authors.initials: VA
authors.lastname: Johnson
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D003376:Counseling / Q000639:trends; D004352:Drug Resistance, Microbial; D004358:Drug Therapy / Q000639:trends; D005260:Female; D015658:HIV Infections / Q000517:prevention & control*; D006679:HIV Seropositivity; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000517:prevention & control*; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D009657:North Carolina; D010349:Patient Compliance; D011247:Pregnancy; D015215:Zidovudine / Q000627:therapeutic use*
chemical_list: D019380:Anti-HIV Agents; D015215:Zidovudine