HIV.
Mother-to-child transmission (MTCT) is almost entirely preventable with a combination of interventions--antiretroviral prophylaxis during pregnancy, intrapartum and neonatally, elective caesarean section and avoidance of breastfeeding. In resource-rich settings new paediatric human immuno-deficiency virus (HIV) infections have reached an all-time low due to broad application of these interventions, particularly the widespread use of highly active antiretroviral therapy and no breastfeeding. However, most HIV-infected pregnant women live in developing countries where <10% of them have access to preventative interventions. Although MTCT rates in developed countries are now around 1-2%, rates in developing countries remain very much higher. Although the vast majority of infants born to HIV-infected mothers can thus be protected from acquisition of infection, they would then be exposed to antiretroviral drugs for which there is only limited information on toxicity and long-term safety. However, based on current knowledge, the immense benefits of antiretroviral prophylaxis in reducing MTCT risk far outweigh the potential for adverse effects.
Thorne
Claire
C
Centre for Paediatric Epidemiology and Biostatistics, Institute of Child Health, University College London, 30 Guilford Street, London WC1N 1EH, UK.
Newell
Marie-Louise
ML
D019380:Anti-HIV Agents / Q000627:therapeutic use; D005260:Female; D015658:HIV Infections / Q000151:congenital* / Q000473:pathology / Q000517:prevention & control* / Q000635:transmission / Q000821:virology; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000517:prevention & control*
D019380:Anti-HIV Agents