title: Vertical transmission of human immunodeficiency virus.
abstract: Sensitive detection methods, such as DNA PCR and RNA PCR suggest that vertical transmission of human immunodeficiency virus (HIV) occurs at three major time periods; in utero, around the time of birth, and postpartum as a result of breastfeeding (Fig. 1). Detection of proviral DNA in infant's blood at birth suggests that transmission occurred prior to delivery. A working definition for time of infection is that HIV detection by DNA PCR in the first 48 h of life indicates in utero transmission, while peripartum transmission is considered if DNA PCR is negative the first 48 h, but then it is positive 7 or more days later [1]. Generally, in the breastfeeding population, breast milk transmission is thought to occur if virus is not detected by PCR at 3-5 months of life but is detected thereafter within the breastfeeding period [2]. Using these definitions and guidelines, studies has suggested that in developed countries the majority, or two thirds of vertical transmission occur peripartum, and one-third in utero [3-6]. The low rate of breastfeeding transmission is due to the practice of advising known HIV-positive mothers not to feed breast milk. However, since the implementation of antiretroviral treatment in prophylaxis of HIV-positive mothers, some studies have suggested that in utero infection accounts for a larger percentage of vertical transmissions [7]. In developing countries, although the majority of infections occurs also peripartum, a significant percentage, 10-17%, is thought to be due to breastfeeding [2, 8, 9].
authors.affiliation: Institute of Microbiology, Medical and Health Science Center, University of Debrecen, Nagyerdei krt. 98, H-4012 Debrecen, Hungary.
authors.forename: F D
authors.initials: FD
authors.lastname: Tóth
authors.forename: A
authors.initials: A
authors.lastname: Bácsi
authors.forename: Z
authors.initials: Z
authors.lastname: Beck
authors.forename: J
authors.initials: J
authors.lastname: Szabó
mesh_terms: D001942:Breast Feeding / Q000009:adverse effects; D004279:DNA, Viral / Q000097:blood / Q000235:genetics; D036861:Delivery, Obstetric; D005321:Extraembryonic Membranes / Q000821:virology; D005260:Female; D005312:Fetal Blood / Q000821:virology; D014644:Genetic Variation; D015658:HIV Infections / Q000276:immunology / Q000635:transmission* / Q000821:virology; D015497:HIV-1 / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D007743:Labor, Obstetric; D010920:Placenta / Q000821:virology; D016133:Polymerase Chain Reaction; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000276:immunology / Q000821:virology; D011533:Proviruses / Q000235:genetics / Q000302:isolation & purification
chemical_list: D004279:DNA, Viral