Options for prevention of HIV transmission from mother to child, with a focus on developing countries.
Use of antiretroviral drugs among HIV-infected pregnant women in many developed countries has significantly reduced rates of mother-to-child HIV transmission, demonstrating that this route of transmission is amenable to intervention. Prevention of transmission in developing countries has proved to be more difficult, although recent advances in short-course antiretroviral drug interventions have made it an immediate possibility, rather than a distant hope as it was seen to be in the recent past. Non-antiretroviral drug interventions, including washing of the birth canal with antiseptic solution and micronutrient supplementation, have not been found to be effective at interrupting mother-to-child HIV transmission, but may have other benefits for maternal and child health. An important issue for developing countries is prevention of postnatal HIV transmission through breast feeding. In most developing countries, formula feeding is not a reasonable option, given the higher rates of mortality from diarrheal and respiratory disease associated with avoidance of all breast feeding. A promising new line of research has recently been broached with the findings from a study in South Africa, which demonstrated that exclusive breast feeding is associated with a significant reduction in postnatal transmission of HIV.
Kuhn
Louise
L
Gertrude H. Sergievsky Center, College of Physicians & Surgeons, Columbia University, and Department of Epidemiology, Joseph L. Mailman School of Public Health, New York 10032, USA. lk24@columbia.edu
Peterson
Ingrid
I
D019380:Anti-HIV Agents / Q000627:therapeutic use; D001942:Breast Feeding / Q000706:statistics & numerical data; D003906:Developing Countries / Q000706:statistics & numerical data; D005260:Female; D015658:HIV Infections / Q000276:immunology / Q000517:prevention & control* / Q000635:transmission*; D006801:Humans; D007223:Infant; D018445:Infectious Disease Transmission, Vertical; D011247:Pregnancy; D016032:Randomized Controlled Trials as Topic / Q000379:methods / Q000706:statistics & numerical data
D019380:Anti-HIV Agents