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Prevention of Perinatal HIV Transmission

Current Status and Future Developments in Anti-Retroviral Therapy

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Abstract

Significant progress has been made in the battle against transmission of HIV-1 from mother to infant. Antiretroviral regimens covering the later part of gestation, labour and the first few weeks of neonatal life have shown great efficacy in reducing such transmission. With the advent of combination antiretroviral therapies, transmission rates lower than 2% have been achieved in clinical studies. Elective caesarean delivery has been shown to enhance the benefit of antiretroviral regimens; however, the risks associated with this approach in many resource-poor settings in developing countries limit its role worldwide. Abbreviated antiretroviral regimens covering labour and the first few days of neonatal life have shown considerable promise in the developing world, resulting in 50% reduction in transmission.

Several questions and challenges remain, however. Amongst them, choice of the optimal antiretroviral agent(s), evaluation of purely post-exposure neonatal prophylaxis, availability of antiretroviral agents in developing countries, long-term safety of antiretroviral therapy during pregnancy and early neonatal life, and the problem of breastfeeding transmission in the developing world are some issues that need urgent attention.

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Acknowledgements

The author would like to thank Drs Ann Duerr, Marc Bulterys and Taha Taha for their critical comments and suggestions in reviewing the manuscript. No sources of funding were used to assist in the preparation of this manuscript. The author has no conflicts of interest that are directly relevant to the content of this manuscript.

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  1. Eastern Virginia Medical School, Norfolk, Virginia, USA

    Athena P. Kourtis

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Kourtis, A.P. Prevention of Perinatal HIV Transmission. Drugs 62, 2213–2220 (2002). https://doi.org/10.2165/00003495-200262150-00004

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