[HIV transmission from mother to child--can the epidemic be stopped?].
BACKGROUND
HIV (human immunodeficiency virus) may be transmitted from mother to child during pregnancy, delivery and breast-feeding. Transmission can be prevented, and efficient methods have caused vertical transmission to become rare in Europe and the USA. The article discusses the global HIV epidemic among children and challenges in reducing transmission from HIV-positive mothers.


METHODS
The article is based on literature retrieved through a non-systematic search in Medline and experience from working as a paediatrician in Botswana.


RESULTS
HIV transmission from mother to child can be reduced from about 30 % to 4 % with relatively simple measures. In many high-endemic areas in Sub-Saharan Africa, little is done to prevent HIV transmission to neonates. Major challenges exist in identifying pregnant women with HIV, especially in areas which lack pregnancy surveillance programmes.


CONCLUSIONS
To prevent neonatal transmission, safe feeding practices should be encouraged and retroviral drugs should be available. The increasing focus and investments in HIV prevention are possible explanations for the decline of the epidemic.
Princess Marina Hospital, Gaborone, Botswana. ketil.stoerdal@c2i.net
Ketil
K
Størdal
D017954:Africa South of the Sahara / Q000453:epidemiology; D019380:Anti-HIV Agents / Q000627:therapeutic use; D001942:Breast Feeding; D003906:Developing Countries; D004196:Disease Outbreaks / Q000517:prevention & control; D005260:Female; D014943:Global Health; D006679:HIV Seropositivity / Q000635:transmission*; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000821:virology; D012307:Risk Factors
D019380:Anti-HIV Agents
Hivsmitte fra mor til barn--kan epidemien stoppes?