Hot Topics in Infection and Immunity in Children VI

Volume 659 of the series Advances in Experimental Medicine and Biology pp 57-71


Why Are Some Babies Still Being Infected with HIV in the UK?

  • Aubrey CunningtonAffiliated withImmunology Unit, London School of Hygiene and Tropical Medicine Email author 
  • , Sanjay PatelAffiliated withDepartment of Paediatric Infectious Diseases, St Mary’s Hospital
  • , Hermione LyallAffiliated withImperial College Healthcare NHS Trust, St. Mary’s Hospital

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In the absence of, the risk of transmission of HIV from a mother to her baby can be reduced from 35 to 0.1% with optimal management and exclusion of breastfeeding. However, the reality is that transmission rates in the UK and Ireland are 10 fold higher than this, at approximately 1%. The reasons for this are complex, but mainly they reflect a failure to detect all women with HIV in pregnancy and system failures that result in missed opportunities for risk reduction. Here we review the mechanisms and risk factors for mother to child transmission (MTCT) of HIV, the current guidelines for prevention of MTCT, and the results and recommendations from a recent study of cases of MTCT in the UK. Finally, we use an instructive clinical scenario to illustrate the need for all healthcare workers to be aware of the guidelines for prevention of MTCT of HIV when dealing with pregnant women and their babies.