Skip to main content

Advertisement

Log in

Vertical Transmission of HIV–An Update

  • Special Article
  • Published:
The Indian Journal of Pediatrics Aims and scope Submit manuscript

Abstract

One of the greatest successes in AIDS research to date has by far been the discovery of successful interventions that interrupt the transmission of HIV from mother to child. It is however important to note that these successes have occurred largely in countries with great resources and the least burden of perinatal transmission of HIV. In the developing world wherein currently 95% of vertical transmission of HIV occurs, it is highly condemnable that still every minute an infected infant is said to be born in spite of the fact that vertical transmission is largely preventable, mainly because translating knowledge into practice is not always possible or feasible; This has led to a continuous growing numbers of children with HIV, thereby making pediatric HIV a looming problem rapidly draining the already burdened health care system of these countries. It is the need of the hour to appropriately address the challenges to achieve zero percent transmission of HIV from an infected mother to her child thereby giving a hope for an AIDS-free new generation worldwide.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. UNAIDS. AIDS epidemic update. December 2007. Available at http://data.unaids.org/pub/EPISlides/2007/2007_epiupdate_en.pdf. Accessed on February 20th, 2010.

  2. UNAIDS. 2008 report on the global AIDS epidemic. Geneva; 2008. Available at http://www.unaids.org/en/KnowledgeCentre/HIVData/Global Report/2008. Accessed on February 20th, 2010.

  3. UNGASS Country Progress Report 2008: India. Available at http://www.india_2008_country_progress_report_en.pdf. Accessed on February 20th, 2010.

  4. De Cock KM, Fowler MG, Mercier E, de Vincenzi I, Saba J, Hoff E, et al. Prevention of mother-to-child HIV transmission in resource-poor countries: translating research into policy and practice. Jama. 2000;283(9):1175–82.

    Article  PubMed  Google Scholar 

  5. Five Phases of prevention of mother-to-child transmission. Available at http://www.dec.org/pdf docs/PNACN748.pdf. Accessed on February 20th, 2010.

  6. Towards universal access : scaling up priority HIV/AIDS interventions in the health sector: progress report 2008. Available at http://www.who.int/hivtowards_universal_access_report_2008.1.pdf.pdf. Accessed on February 20th, 2010.

  7. Perinatal HIV Guidelines Working Group. Public Health Service Task Force recommendations for use of antiretroviral drugs in pregnant HIV-infected women for maternal health and interventions to reduce perinatal HIV transmission in the United States. April 29, 2009; pp 1–90. Available at http://aidsinfo.nih.gov/ContentFiles/PerinatalGL.pdf. Accessed: February 20th, 2010.

  8. Cooper ER, Charurat M, Mofenson L, Hanson IC, Pitt J, Diaz C, et al. Combination antiretroviral strategies for the treatment of pregnant HIV-1-infected women and prevention of perinatal HIV-1 transmission. J AcquirImmune Defic Syndr. 2002;29:484–94.

    CAS  Google Scholar 

  9. European Collaborative Study. Mother-to-child transmission of HIV infection in the era of highly active antiretroviral therapy. Clin Infect Dis. 2005;40:458–65.

    Article  Google Scholar 

  10. Merchant RH, Lala MM. Prevention of mother-to-child transmission of HIV—an overview. Indian J Med Res. 2005;121:489–501.

    PubMed  Google Scholar 

  11. Arrive E, Newell M-L, Ekouevi DK, et al. Prevalence of resistance to nevirapine in mothers and children after single-dose exposure to prevent vertical transmission of HIV-1: a meta-analysis. Int J Epidemiol. 2007;36:1009–21.

    Article  PubMed  Google Scholar 

  12. Loubser S, Balfe P, Sherman G, Hammer S, Kuhn L, Morris L. Decay of K103N mutants in cellular DNA and plasma RNA after single-dose nevirapine to reduce mother-to-child HIV transmission. Aids. 2006;20:995–1002.

    Article  CAS  PubMed  Google Scholar 

  13. Flys T, Nissley DV, Claasen CW, Jones D, Shi C, Guay LA, et al. Sensitive drug resistance assays reveal long-term persistence of HIV-1 variants with the K103N nevirapine (NVP) resistance mutation in some women and infants after the administration of single-dose NVP: HIVNET 012. J Infect Dis. 2005;192:24–9.

    Article  CAS  PubMed  Google Scholar 

  14. Martinson NA, Ekouevi DK, Dabis F, Morris L, Lupodwana P, Tonwe-Gold B, et al. Transmission rates in consecutive pregnancies exposed to single-dose nevirapine in Soweto, South Africa and Abidjan, Cote d’Ivoire. J Acquir Immune Defic Syndr. 2007;45:206–9.

    Article  CAS  PubMed  Google Scholar 

  15. Michelle S, McConnell PB, Chineta E, et al. Effectiveness of repeat single-dose nevirapine for prevention of mother-to-child transmission of HIV-1 in repeat pregnancies in Uganda. J Acquir Immune Defic Syndr. 2007;46:291–6.

    Article  Google Scholar 

  16. McConnell M, Bakaki P, Eure C, Mubiru M, Bagenda D, Downing R, et al. Effectiveness of repeat single-dose nevirapine for prevention of mother-to-child transmission of HIV-1 in repeat pregnancies in Uganda. J Acquir Immune Defic Syndr. 2007;46:291–6.

    Article  PubMed  Google Scholar 

  17. Jourdain G, Ngo-Giang-Huong N, Le Coeur S, Bowonwatanuwong C, Kantipong P, Leechanachai P, et al. Intrapartum exposure to nevirapine and subsequent maternal responses to nevirapine-based antiretroviral therapy. N Engl J Med. 2004;351:229–40.

    Article  CAS  PubMed  Google Scholar 

  18. Lockman S, Shapiro RL, Smeaton LM, Wester C, Thior I, Stevens L, et al. Response to antiretroviral therapy after a single, peripartum dose of nevirapine. N Engl J Med. 2007;356:135–47.

    Article  CAS  PubMed  Google Scholar 

  19. Eshleman SH, Hoover DR, Chen S, Hudelson SE, Guay LA, Mwatha A, et al. Nevirapine (NVP) resistance in women with HIV-1 subtype C, compared with subtypes A and D, after the administration of single-dose NVP. J Infect Dis. 2005;192:30–6.

    Article  CAS  PubMed  Google Scholar 

  20. Eshleman SH, Becker-Pergola G, Deseyve M, Guay LA, Mracna M, Fleming T, et al. Impact of human immunodeficiency virus type 1 (hiv-1) subtype on women receiving single-dose nevirapine prophylaxis to prevent hiv-1 vertical transmission (hiv network for prevention trials 012 study). J Infect Dis. 2001;184:914–7.

    Article  CAS  PubMed  Google Scholar 

  21. Mandelbrot L, Landreau-Mascaro A, Rekacewicz C, Berrebi A, Benifla JL, Burgard M, et al. Lamivudine-zidovudine combination for prevention of maternal-infant transmission of HIV-1. Jama. 2001;285:2083–93.

    Article  CAS  PubMed  Google Scholar 

  22. Giuliano M, Palmisano L, Galluzzo CM, Amici R, Germinario E, Okong P, et al. Selection of resistance mutations in pregnant women receiving zidovudine and lamivudine to prevent HIV perinatal transmission. Aids. 2003;17:1570–2.

    Article  PubMed  Google Scholar 

  23. Bardeguez AD, Shapiro DE, Mofenson LM, Coombs R, Frenkel LM, Fowler MG, et al. Effect of cessation of zidovudine prophylaxis to reduce vertical transmission on maternal HIV disease progression and survival. J Acquir Immune Defic Syndr. 2003;32:170–81.

    CAS  PubMed  Google Scholar 

  24. Palumbo P, Holland B, Dobbs T, Pau CP, Luo CC, Abrams EJ, et al. Antiretroviral resistance mutations among pregnant human immunodeficiency virus type 1-infected women and their newborns in the United States: vertical transmission and clades. J Infect Dis. 2001;184:1120–6.

    Article  CAS  PubMed  Google Scholar 

  25. Spanish Perinatal Guidelines. Recomendaciones de la SPNS/GESIDA/SEGO/AEP Para el Seguimiento de la infeccion por el VIH conrelacion a la reproduccion, el embarazo y la prevencion de la transmision vertical. 2008. Available at http://www.msc.es/ciudadanos/enfLesiones/enfTransmisibles/sida/vigilancia/home.htm. Accessed on February 20th, 2010.

  26. Roberts SS, Martinez M, Covington DL, Rode RA, Pasley MV, Woodward WC. Lopinavir/ritonavir in pregnancy. J Acquir Immune Defic Syndr. 2009;51:456–61.

    Article  CAS  PubMed  Google Scholar 

  27. Revised WHO recommendations on the use of antiretroviral drugs for treating pregnant women and preventing HIV infection in infants. 2009. Available at http://www.who.int/hiv/topics/mtct/. Accessed on February 20th, 2010.

  28. McIntyre JA, Hopley M, Moodley D, Eklund M, Gray GE, Hall DB, et al. Efficacy of short-course AZT Plus 3TC to reduce nevirapine resistance in the prevention of mother-to-child HIV transmission: a randomized clinical trial. PLoS Medicine. 2009;6:10.

    Article  Google Scholar 

  29. Chi BH, Sinkala M, Mbewe F, Cantrell RA, Kruse G, Chintu N, et al. Single-dose tenofovir and emtricitabine for reduction of viral resistance to non-nucleoside reverse transcriptase inhibitor drugs in women given intrapartum nevirapine for perinatal HIV prevention: an open-label randomised trial. Lancet. 2007;370:1698–705.

    Article  CAS  PubMed  Google Scholar 

  30. Rapid advice: use of antiretroviral drugs for treating pregnant women and preventing HIV Infection in infants. WHO 2009. Available at http://www.who.int/hiv/pub/mtct/rapid_advice_mtct.pdf. Accessed on February 20th, 2010.

  31. Merchant RH, Changedia S. Prevention of vertical transmission of human immunodeficiency virus. Indian Pediatr. 1997;34:475–80.

    CAS  PubMed  Google Scholar 

  32. Merchant RH, Damania K, Gilada IS, Bhagwat RV, Karkare JS, Oswal JS, et al. Strategy for preventing Vertical transmisssion of HIV: Bombay experience. Indian Pediatr. 2001;38:132–8.

    CAS  PubMed  Google Scholar 

  33. Lallemant M, Jourdain G, LeCouer S, et al. Single dose perinatal nevirapine plus standard zidovudine to prevent mother-to-child transmission of HIV-1 in Thailand. N Engl J Med. 2004;351:217–28.

    Article  PubMed  Google Scholar 

  34. Shapiro D, Tuomala R, Pollack H, et al. Mother-to child HIV transmission risk according to antiretroviral therapy, mode of delivery, and viral load in 2895 U.S. women (PACTG 367). 11th Conference on Retroviruses and Opportunistic Infections; February 8–11, 2004; San Francisco, CA. Abstract 99.

  35. BHIVA/CHIVA guidelines on the management of HIV infection in pregnant women. 2008. Available at http://www.bhiva.org/guidelines/2005/BHIVA-guidelines. Accessed on February 20th, 2010.

  36. Leroy V et al. Is there a difference in the efficacy of peripartum antiretroviral regimens in reducing mother-to-child transmission of HIV in Africa? AIDS. 2005;19(16):1865–75.

    Article  PubMed  Google Scholar 

  37. WHO. Antiretroviral drugs for treating pregnant women and preventing HIV infection in infants in resource-limited countries: towards universal access. Recommendations for a public health approach. Geneva: WHO; 2006. Available at http://www.who.int/hiv/pub/guidelines/WHOPMTCT.pdf. Accessed on February 20th, 2010.

  38. De Cock KM, Fowler MG, Mercier E, de Vincenzi I, Saba J, Hoff E, et al. Prevention of mother-to-child HIV transmission in resource-poor countries: translating research into policy and practice. Jama. 2000;283:1175–82.

    Article  PubMed  Google Scholar 

  39. Coutsoudis A, Dabis F, Fawzi W, Gaillard P, Haverkamp G, Harris DR, et al. Late postnatal transmission of HIV-1 in breast-fed children: an individual patient data meta-analysis. J Infect Dis. 2004;189:2154–66.

    Article  PubMed  Google Scholar 

  40. Nduati R, John G, Mbori-Ngacha D, Richardson B, Overbaugh J, Mwatha A, et al. Effect of breastfeeding and formula feeding on transmission of HIV-1: a randomized clinical trial. Jama. 2000;283:1167–74.

    Article  CAS  PubMed  Google Scholar 

  41. Embree JE, Njenga S, Datta P, Nagelkerke NJ, Ndinya-Achola JO, Mohammed Z, et al. Risk factors for postnatal mother-child transmission of HIV-1. AIDS. 2000;14:2535–41.

    Article  CAS  PubMed  Google Scholar 

  42. Rapid advice: revised WHO principles and recommendations on infant feeding in the context of HIV. November 2009. Available at http://www.who.int/hiv/pub/mtct/rapid_advice_mtct_infantfeeding.pdf. Accessed on February 20th, 2010.

  43. Reeves JD, Doms RW. Human immunodeficiency virus type 2. J Gen Virol. 2002;83:1253–65.

    CAS  PubMed  Google Scholar 

  44. National AIDS Control Organization. Guidelines for HIV care & treatment infants & children. 2006. Available at http://www.nacoonline.org/NACO/. Accessed on February 21th, 2010.

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Mamatha M. Lala.

Additional information

Throughout this document, except in the last section which has been dedicated to HIV-2, HIV refers to HIV-1.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lala, M.M., Merchant, R.H. Vertical Transmission of HIV–An Update. Indian J Pediatr 77, 1270–1276 (2010). https://doi.org/10.1007/s12098-010-0184-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12098-010-0184-0

Keywords

Navigation