Perinatal HIV and Its Prevention: Progress Toward an HIV-free Generation

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Date
2010Author
Fowler, Mary Glenn
Gable, Alicia R.
Lampe, Margaret A.
Etima, Monica
Owor, Maxensia
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Show full item recordAbstract
Since the first cases of infant HIV infection were described in the early 1980s, significant
progress has been made in our understanding of risk factors for mother-to-child
transmission (MTCT) of HIV as well as effective interventions to prevent transmission.
MTCT of the human immunodeficiency virus type-1 (HIV-1) can occur during pregnancy
particularly in the third trimester, during the intrapartum period, and for infants
exposed to HIV, who are breastfed, throughout the period of lactation.1 Before the
availability of antiretroviral and obstetric interventions, about 1 in 4 infants born to
women infected with HIV became infected. Among these infected infants, 50% to
60% of transmission occurred around the time of labor or delivery based on newborn
infants exposed to HIV having negative cord blood or newborn polymerase chain
reaction (PCR) tests that subsequently became positive within the first weeks of
life.2 Among HIV-infected breastfeeding populations, about 20% to 25% of infections
occurred in utero based on positive PCRs at birth; 35% to 50% intrapartum; and
another 25% to 35% of infants negative at birth and in the first 6 weeks became
infected later, presumably as a result of transmission through breast milk.
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