[HIV infection in children and the prevention of mother-to-child transmission].
The introduction of highly active antiretroviral therapy (HAART) has led to a major improvement in the prognosis of paediatric HIV in the developed world. HIV infected children in the Netherlands exhibit a broad range of social-cultural backgrounds and many of them grow up in multiple-problem families. As well as the impact of HIV itself, these families struggle with social, economic and emotional disadvantages that interfere with an optimal treatment. The failure of HAART and the development of HIV resistant strains resulting from non-compliance are increasingly being observed. For an optimal support of these children and families, an integrated medical and psychosocial service is required. HAART during pregnancy and delivery as well as post-exposure prophylaxis to the neonate have significantly decreased the risk of HIV transmission from mother to child. Due to the implementation of national guidelines and the effort of HIV-internists, obstetricians, midwives and paediatricians, less transmission cases have occurred in the Netherlands in recent years, despite an increasing number of exposed infants. The goal is to detect and treat every pregnant HIV-infected woman and her baby.
Universitair Medisch Centrum, Wilhelmina Kinderziekenhuis, afd. Algemene Kindergeneeskunde en Infectieziekten, Postbus 85.090, 3508 AB Utrecht. s.geelen@wkz.azu.nl
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D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D002648:Child; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000517:prevention & control / Q000635:transmission*; D006679:HIV Seropositivity / Q000175:diagnosis* / Q000188:drug therapy / Q000635:transmission; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008431:Maternal-Fetal Exchange; D009426:Netherlands; D010349:Patient Compliance; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy*; D011379:Prognosis; D016019:Survival Analysis