Abstract
<h2>Abstract</h2> During 2003, 660,000 children were infected with HIV in utero, during delivery or post-partum through breast-feeding. HIV transmission can be almost completely prevented by exclusive formula-feeding, pre-labour Caesarean section and antiretroviral therapy. Single-dose nevirapine has been shown to be effective in reducing peripartum transmission, but the rapid development of resistance is an increasing concern in non-breast-feeding populations. Zidovudine monotherapy plus pre-labour Caesarean section is associated with less than 1% transmission. Effective combination therapies that reduce maternal viraemia to below the limit of detection are likely to be similarly or more effective. The role of pre-labour Caesarean section in women with a plasma HIV RNA load of less than 50 copies/ml is uncertain. The toxicities of combination antiretroviral therapy in women and their babies must be carefully balanced against the benefits.
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