Prevention of Mother-to-child Transmission of HIV

Abstract

Introduction Over the past several years, major successes have been achieved in prevention of mother-to-child transmission (MTCT) of human immunodeficiency virus type 1 (HIV). However, these successes have occurred primarily in those countries with the greatest resources and the lowest burden of HIV infection among women and children. Significant challenges remain, particularly in those countries with more limited resources and a greater population burden of HIV infection. Each day an estimated 2000 infants become infected with HIV, virtually all residing in resource-poor settings [1]. MTCT of HIV can occur during pregnancy, at the time of labor and delivery, and postnatally (through breastfeeding) [2]. Rates of MTCT of HIV have been calculated in studies conducted around the world in the absence of interventions to decrease transmission [3]. Overall, most studies reported a transmission rate in the range of 25%–30% and higher transmission rates were observed in resource-poor settings (13%–42%) than in resource-rich settings (14%–25%). In this chapter, risk factors for MTCT of HIV will be reviewed briefly. In addition, interventions for the prevention of MTCT of HIV will be discussed, both those already shown to be efficacious and those under study. Finally, strategies to prevent MTCT of HIV will be addressed. Risk factors for, and interventions to prevent, mother-to-child transmission of HIV Numerous risk factors for MTCT of HIV have been identified or are under investigation [4].