Prevention of mother-to-child HIV transmission in resource-poor countries: translating research into policy and practice.
Each year, an estimated 590,000 infants acquire human immunodeficiency virus type 1 (HIV) infection from their mothers, mostly in developing countries that are unable to implement interventions now standard in the industrialized world. In resource-poor settings, the HIV pandemic has eroded hard-won gains in infant and child survival. Recent clinical trial results from international settings suggest that short-course antiretroviral regimens could significantly reduce perinatal HIV transmission worldwide if research findings could be translated into practice. This article reviews current knowledge of mother-to-child HIV transmission in developing countries, summarizes key findings from the trials, outlines future research requirements, and describes public health challenges of implementing perinatal HIV prevention interventions in resource-poor settings. Public health efforts must also emphasize primary prevention strategies to reduce incident HIV infections among adolescents and women of childbearing age. Successful implementation of available perinatal HIV interventions could substantially improve global child survival.
De Cock
K M
KM
Division of HIV/AIDS Prevention-Surveillance and Epidemiology, National Center for HIV, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. kmd2@cdc.gov
Fowler
M G
MG
Mercier
E
E
de Vincenzi
I
I
Saba
J
J
Hoff
E
E
Alnwick
D J
DJ
Rogers
M
M
Shaffer
N
N
D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D001942:Breast Feeding; D002986:Clinical Trials as Topic; D003906:Developing Countries; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission*; D015497:HIV-1; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D011050:Policy Making; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control*; D011634:Public Health / Q000592:standards; D012106:Research
D019380:Anti-HIV Agents