Transmission of HIV-1 from mother to infant.
In the developed world, antiretroviral therapy (ART) administered to the mother during pregnancy and intrapartum and to the infant in the neonatal period has resulted in a reduction of the overall risk of vertical transmission of HIV-1 to approximately 8%. In some settings, ART combined with cesarean section and a reduction in duration of ruptured membranes has resulted in a further lessening of risk to levels < or = 2 percent. A number of less expensive and greatly abbreviated ART regimens, useful for application in resource poor settings, also have resulted in reductions of mother-to-infant transmission of HIV-1 by 33 to 50% compared to baseline. A multitude of studies have shown these drugs to be safe for mothers, fetuses, and newborns. Breastfeeding seems to represent a risk factor that adds to the risk of vertical transmission, especially in infants who are fed a combination of breastmilk and other liquids and solids. Studies designed to assess the possible benefits of treating genital ulcer disease, chorioamnionitis, mastitis, and malnutrition in HIV-infected women, and of applying antiseptic washes to the cervix and vagina during labor, are in progress.
Andiman
Warren A
WA
Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut 06520-8064, USA. warren.andiman@yale.edu
D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D001942:Breast Feeding; D002986:Clinical Trials as Topic; D005260:Female; D015658:HIV Infections / Q000151:congenital / Q000517:prevention & control / Q000635:transmission*; D015497:HIV-1; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000503:physiopathology*
D019380:Anti-HIV Agents