title: Thinking about HIV infection.
abstract: Mother-to-child transmission of HIV can occur during pregnancy, labor, delivery, and breastfeeding. Evidence-based interventions (routine screening of pregnant women, initiation of antiretroviral drugs for mother's treatment or prevention of MTCT, and avoiding breastfeeding) have reduced transmission rates in the United States from 25% to 30% to less than 2%. Triple-drug combination antiretroviral therapy effectively controls HIV infection and improves survival and quality of life for HIV-infected children and adolescents. Initial regimens use combinations of two NRTIs together with an NNRTI or a ritonavir-boosted PI. These regimens have been shown to increase CD4 counts and achieve virologic suppression. Prevention of serious and opportunistic infections reduces morbidity and mortality in children and adolescents who have HIV infection. Recommendations for immunizations and chemoprophylaxis vary with the patient's CD4 count. Condoms made from latex, polyurethane, or other synthetic materials have been shown to decrease the transmission of STIs, including HIV infection.
authors.affiliation: Division of General Pediatrics & Adolescent Medicine, Johns Hopkins University School of Medicine, Baltimore, Md., USA.
authors.forename: Evelyn P
authors.initials: EP
authors.lastname: Simpkins
authors.forename: George K
authors.initials: GK
authors.lastname: Siberry
authors.forename: Nancy
authors.initials: N
authors.lastname: Hutton
mesh_terms: D000293:Adolescent; D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D002648:Child; D003376:Counseling; D004279:DNA, Viral / Q000235:genetics; D005260:Female; D006678:HIV / Q000235:genetics; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy* / Q000635:transmission; D006801:Humans; D007223:Infant; D008297:Male; D010287:Parent-Child Relations; D011247:Pregnancy; D011295:Prenatal Care; D012333:RNA, Messenger / Q000235:genetics; D012367:RNA, Viral / Q000235:genetics; D012725:Sexual Behavior; D019966:Substance-Related Disorders / Q000175:diagnosis; D019562:Viral Load; D055815:Young Adult
chemical_list: D044966:Anti-Retroviral Agents; D004279:DNA, Viral; D012333:RNA, Messenger; D012367:RNA, Viral