HIV in pregnancy.
OBJECTIVE
This review discusses recent articles on various aspects of the prevention of mother-to-child transmission during pregnancy and delivery.


RESULTS
Rapid human immunodeficiency virus (HIV) testing of women in labour whose status is not known allows the prompt treatment of mother and baby to reduce transmission risk. The feared clinical resistance in the mother after treatment with a single dose of nevirapine has been confirmed. Strategies are required to minimize this resistance and allow the use of nevirapine for treatment of the mother. There are new findings of mitochondrial toxicity in babies who have been exposed to anti-retroviral medicines during pregnancy or delivery, but the clinical implications are not clear. Long-term follow-up of exposed children is required. Resource-poor countries are starting to use multiple drugs to further reduce transmission to the infant. These efforts are reducing the rates of transmission to the level found in affluent countries.


CONCLUSIONS
Improvements in treatment continue to reduce the risk of HIV transmission from mother to child in resource-poor countries, but subsequent maternal resistance continues to be a problem since treatment for the mother's health is now possible. The long-term effects on the infant are still not understood.
Moodley
Jack
J
aMRC/UN Pregnancy Hypertension Research Unit and Department of Obstetrics and Gynaecology, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa. gynae@ukzn.ac.za
Wennberg
Jens L
JL
D044966:Anti-Retroviral Agents / Q000493:pharmacokinetics / Q000627:therapeutic use; D001942:Breast Feeding; D002585:Cesarean Section; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy / Q000635:transmission*; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000821:virology; D012307:Risk Factors; D019562:Viral Load
D044966:Anti-Retroviral Agents