Trends in human immunodeficiency virus (HIV) counseling, testing, and antiretroviral treatment of HIV-infected women and perinatal transmission in North Carolina.
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.
Fiscus
S A
SA
Department of Microbiology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC 27599-7140, USA. sfiscus@email.unc.edu
Adimora
A A
AA
Schoenbach
V J
VJ
McKinney
R
R
Lim
W
W
Rupar
D
D
Kenny
J
J
Woods
C
C
Wilfert
C
C
Johnson
V A
VA
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*
D019380:Anti-HIV Agents; D015215:Zidovudine