Skip to main content
SpringerLink
Log in

Prevention of Vertical Transmission of HIV in Resource-Limited Countries

  • Chapter
  • First Online:
Hot Topics in Infection and Immunity in Children VII

Part of the book series: Advances in Experimental Medicine and Biology ((AEMB,volume 697))

Abstract

Prevention of vertical (i.e., mother-to-child) transmission of HIV is essential to reduce significant HIV-related child morbidity and mortality in developing countries. Globally, pediatric infections comprise about 15% of all new HIV infections each year and virtually all pediatric infections can be prevented by eliminating vertical transmission [1]. The World Health Organization (WHO) recommendations (revised in 2006) for prevention of mother-to-child transmission (PMTCT)1 include a four-pronged comprehensive strategy [2]. Although we acknowledge the critical role that all approaches play in reducing pediatric HIV infection, the focus of this chapter is on strategies that address the third prong: preventing HIV transmission from infected mothers to their infants. Considerable achievements have been made on this front, including many clinical trials demonstrating good efficacy.

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

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Notes

  1. 1.

    Since submission, the WHO has released revised PMTCT guidelines available at: http://www.who.int/hiv/pub/mtct/advice/en/index.html.

References

  1. Joint United Nations Program on HIV/AIDS (UNAIDS). Status of Global HIV Epidemic. Geneva: UNAIDS; 2008.

    Google Scholar 

  2. World Health Organization (WHO). Antiretroviral Drugs for Treating Pregnant Women and Preventing HIV Infection in Infants in Resource-Limited Settings: Towards Universal Access. Geneva: WHO; 2006.

    Google Scholar 

  3. United Nations Children’s Fund (UNICEF), UNAIDS, and WHO. Towards Universal Access: Scaling Up Priority HIV/AIDS Interventions in the Health Sector. Progress Report 2008. New York, NY: UNICEF; 2008.

    Google Scholar 

  4. Sripipatana T, Spensley A, Miller A et al. Site-specific interventions to improve prevention of mother-to-child transmission of human immunodeficiency virus programs in less developed settings. Am J Obstet Gynecol. 2007;197(3 Suppl):S107–12. Review.

    Article  PubMed  Google Scholar 

  5. Spensley A, Sripipatana T, Turner AN, Hoblitzelle C, Robinson J, Wilfert C; Elizabeth Glaser Pediatric AIDS Foundation Prevention of Mother-to-Child Transmission of HIV Group. Preventing mother-to-child transmission of HIV in resource-limited settings: the Elizabeth Glaser Pediatric AIDS Foundation experience. Am J Public Health. 2009;99(4):631–37. Epub 13 Aug 2008.

    Article  PubMed  Google Scholar 

  6. Plipat T, Naiwatankul T, Rattanasuporn N et al. Reduction in mother-to-child transmission of HIV in Thailand, 2001-2003: results from population-based surveillance in six provinces. AIDS. 2007;21(2):145–51.

    Article  PubMed  Google Scholar 

  7. Tlale J, Keapoletswe K, Anderson MG, de la Hoz Gomez D, Mmelesi M, Seipone K Mother-to-child HIV transmission rate in Botswana: analysis of dried blood spots (DBS) results from the national PMTCT programme. Paper presented at: XVII International AIDS Conference; 3–8 Aug 2008; Mexico City. Abstract ThAC04.

    Google Scholar 

  8. UNICEF. The state of the world’s children 2009. http://www.unicef.org/sowc09/docs/SOWC09-FullReport-EN.pdf. Published December 2008. Accessed 13 Aug 2009.

  9. Elizabeth Glaser Pediatric AIDS Foundation (EGPAF). GLASER program data. Accessed 9 Aug 2009.

    Google Scholar 

  10. Barker P Health systems performance and considerations for implementing PMTCT ARV prophylaxis interventions. Paper presented at: WHO expert consultation on new and emerging evidence on use of ARV drugs for PMTCT of HIV, Geneva, 17–19 Nov 2008.

    Google Scholar 

  11. Stringer EM, Chi BH, Chintu N et al. Monitoring effectiveness of programmes to prevent mother-to-child HIV transmission in lower-income countries. Bull World Health Organ. 2008;86:57–62.

    Article  PubMed  Google Scholar 

  12. Stringer E, Ekouevi D, Coetzee D, Tih P, Creek T, Stinson K, Gigan Coverage of nevirapine-based services to prevent mother to child transmission of HIV-1 in Four African Countries. JAMA. 2010;304(3):293–302.

    Google Scholar 

  13. Stringer JS, Sinkala M, Goldenberg RL et al. Universal nevirapine upon presentation in labor to prevent mother-to-child HIV transmission in high prevalence settings. AIDS. 2004;18(6):939–43.

    Article  CAS  PubMed  Google Scholar 

  14. Kuhn L, Aldrovandi GM, Sinkala M et al. Zambia Exclusive Breastfeeding Study. Effects of early, abrupt weaning on HIV-free survival of children in Zambia. N Engl J Med. 2008;359(2):130–41. Epub 4 June 2008. Erratum in: N Engl J Med. 2008;359(17):1859.

    Article  CAS  PubMed  Google Scholar 

  15. Stinger J Prevention of breast-feeding transmission of HIV-1. Paper presented at: CROI, Montreal, QC, 8–11 Feb 2009. Paper 127.

    Google Scholar 

  16. De Schacht C, Palege C, Salomão M et al. Challenges in improving access to antiretroviral treatment for pregnant women in Gaza Province, Mozambique. Paper presented at: HIV/AIDS Implementers’ Meeting, Kampala, 3–7 June 2008. Abstract 1555.

    Google Scholar 

  17. Ubarijoro S, Mukaminega M, Fitch N Efficacy of providing pre-ART care at PMTCT/VCT sites vs. referral of all HIV+ patients to ART sites. Paper presented at: HIV/AIDS Implementers’ Meeting, Kampala, 3–7 June 2008. Abstract 727.

    Google Scholar 

  18. Mahdi MA, Chouraya C, Kieffer MP, Waligo A, Shabalala F ART services in MCH settings: the Swaziland experience. Paper presented at: XVII International AIDS Conference, Mexico City, 3–8 Aug 2008. Abstract MOPE0158.

    Google Scholar 

  19. Chirwa L, Kamoto K, Nyirenda T et al. Increasing access to anti-retroviral therapy for eligible pregnant women through strategic use of CD4 testing. Paper presented at: HIV/AIDS Implementers’ Meeting, Kampala, 3–7 June 2008. Abstract 1812.

    Google Scholar 

  20. Read J; The Breastfeeding and HIV International Transmission (BHITS) Study Group. 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 

  21. WHO Collaborative Study Team on the Role of Breastfeeding on the Prevention of Infant Mortality. Effect of breast-feeding on infant and child mortality due to infectious diseases in less developed countries: a pooled analysis. Lancet. 2000;355:451–55.

    Google Scholar 

  22. Iliff J, Piwoz EG, Tavengwa NV et al. ZVITAMBO study group. Early exclusive breastfeeding reduces the risk of postnatal HIV-1 transmission and increases HIV-free survival. AIDS. 2005;19:699–708.

    Article  PubMed  Google Scholar 

  23. Jones G, Steketee RW, Black RE, Bhutta ZA, Morris SS. Bellagio child survival study group. How many child deaths can we prevent this year?. Lancet. 2003;362:65–71.

    Article  PubMed  Google Scholar 

  24. Kumwenda NI, Hoover D, Mofenson LM et al. Extended antiretroviral prophylaxis to reduce breast-milk HIV-1 transmission. N Engl J Med. 2008;359:119–29.

    Article  CAS  PubMed  Google Scholar 

  25. Chasela CS, Hudgens MG, Jamieson DJ, et al. for the BAN Study Group*. Maternal or Infant Antiretroviral Drugs to Reduce HIV-1 Transmission. N Engl J Med. 2010;362:2271–81.

    Google Scholar 

  26. WHO. HIV and Infant Feeding, Revised principles and recommendations, rapid advice November 2009.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Elizabeth Glaser Pediatric AIDS Foundation, Los Angeles, USA

    Catherine M. Wilfert, Tabitha Sripipatana, Allison Spensley, Mary Pat Kieffer & Edward Bitarakwate

Authors
  1. Catherine M. Wilfert
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tabitha Sripipatana
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Allison Spensley
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mary Pat Kieffer
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Edward Bitarakwate
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Catherine M. Wilfert .

Editor information

Editors and Affiliations

  1. Royal Children's Hospital, Dept. Pediatrics, University of Melbourne, Flemington Road, Parkville, 3052, Victoria, Australia

    Nigel Curtis

  2. Institute of Child Life and Health, UBHT Education Centre, University of Bristol, Upper Maudlin Street, Bristol, BS2 8AE, United Kingdom

    Adam Finn

  3. University of Oxford, Level 4,John Radcliffe Hospital, Oxford, OX3 9DU, United Kingdom

    Andrew J. Pollard

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Wilfert, C.M., Sripipatana, T., Spensley, A., Kieffer, M.P., Bitarakwate, E. (2011). Prevention of Vertical Transmission of HIV in Resource-Limited Countries. In: Curtis, N., Finn, A., Pollard, A. (eds) Hot Topics in Infection and Immunity in Children VII. Advances in Experimental Medicine and Biology, vol 697. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-7185-2_4

Download citation

Publish with us

Policies and ethics

Search

Navigation