Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-669899f699-7xsfk Total loading time: 0 Render date: 2025-05-07T01:12:02.622Z Has data issue: false hasContentIssue false

4 - Prevention of mother-to-child transmission of HIV

Published online by Cambridge University Press:  23 December 2009

By
Jennifer S. Read
Edited by
Steven L. Zeichner  and
Jennifer S. Read
Jennifer S. Read
Affiliation:
Pediatric, Adolescent, and Maternal AIDS (PAMA) Branch, NICHD, NIH, Bethesda, MD
Steven L. Zeichner
Affiliation:
National Cancer Institute, Bethesda, Maryland
Jennifer S. Read
Affiliation:
National Institutes of Health, Bethesda, Maryland
Get access

Summary

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].

Type
Chapter
Information
Handbook of Pediatric HIV Care , pp. 107 - 133
Publisher: Cambridge University Press
Print publication year: 2006

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Book purchase

Temporarily unavailable

References

UNAIDS. acquired immune deficiency syndrome Epidemic Update: December 2003 (Available at www.unaids.org).
Kourtis, A. P., Bulterys, M., Nesheim, S. R., Lee, F. K.Understanding the timing of human immunodeficiency virus transmission from mother to infant. J. Am. Med. Assoc. 2001;285:709–712.CrossRefGoogle ScholarPubMed
Working Group on Mother-to-Child Transmission of human immunodeficiency virus. Rates of mother-to-child transmission of human immunodeficiency virus-1 in Africa, America, and Europe: results from 13 perinatal studies. J. Acquir. Immune Defic. Syndr. Hum. Retrovirol. 1995;8:506–510.CrossRef
Fowler, M. G., Simonds, R. J., Roongpisuthipong, A.Update on perinatal human immunodeficiency virus transmission. Pediatr. Clin. North Am. 2000;47:21–38.CrossRefGoogle Scholar
Contopoulos-Ioannidis, D. G., Ioannidis, J. P. A.Maternal cell-free viremia in the natural history of perinatal human immunodeficiency virus-1 transmission. J. Acquir. Immune Defic. Syndr. 1998;18: 126–135.CrossRefGoogle Scholar
Mofenson, L. M., Lambert, J. S., Stiehm, E. R.et al.Risk factors for perinatal transmission of human immunodeficiency virus type 1 in women treated with zidovudine. Pediatric acquired immune deficiency syndrome Clinical Trials Group Study 185 Team. N. Engl. J. Med. 1999;341:385–393.CrossRefGoogle Scholar
Cooper, E. R., Charurat, M., Mofenson, L.et al.Combination antiretroviral strategies for the treatment of pregnant human immunodeficiency virus-1-infected women and prevention of perinatal human immunodeficiency virus-1 transmission. J. Acquir. Immune Defic. Syndr. 2002;29:484–494.CrossRefGoogle Scholar
Shapiro, D., Tuomala, R., Pollack, H. et al. Mother-to-child human immunodeficiency virus transmission risk according to antiretroviral therapy, mode of delivery, and viral load in 2895 U. S. women (Pediatric acquired immune deficiency syndrome Clinical Trials Group 367). Eleventh Conference on Retroviruses and Opportunistic Infections (February 2004; San Francisco, CA.), Program and Abstracts. (Abstract S-80).
Connor, E. M., Sperling, R. S., Gelber, R.et al.Reduction of maternal–infant transmission of human immunodeficiency virus type 1 with zidovudine treatment. N. Engl. J. Med. 1994;331:1173–1180.CrossRefGoogle ScholarPubMed
Shaffer, N., Chuachoowong, R., Mock, P. A.et al.Short-course zidovudine for perinatal human immunodeficiency virus-1 transmission in Bangkok, Thailand: a randomised controlled trial. Lancet 1999;353:773–780.CrossRefGoogle ScholarPubMed
Wiktor, S. Z., Ekpini, E., Karon, J. M.et al.Short-course zidovudine for prevention of mother-to-child transmission of human immunodeficiency virus-1 in Abidjan, Cote d'Ivoire: a randomised trial. Lancet 1999;353:781–785.CrossRefGoogle ScholarPubMed
Dabis, F., Msellati, P., Meda, N.et al.6-month efficacy, tolerance and acceptability of a short regimen of oral zidovudine to reduce vertical transmission of human immunodeficiency virus in breastfed children in Cote d'Ivoire and Burkina Faso: a double-blind placebo-controlled multicentre trial. Lancet 1999;353:786–792.CrossRefGoogle Scholar
Leroy, V., Karon, J. M., Alioum, A.et al.Twenty-four month efficacy of a maternal short-course zidovudine regimen to prevent mother-to-child transmission of human immunodeficiency virus-1 in West Africa. acquired immune deficiency syndrome 2002;16:631–641.Google ScholarPubMed
Lallemant, M., Jourdain, G., Coeur, S., et al.A trial of shortened zidovudine regimens to prevent Mother-to-child transmission of human immunodeficiency virus type 1. N. Engl. J. Med. 2000;353:982–991.CrossRefGoogle Scholar
Jackson, J. B., Musoke, P., Fleming, T.et al.Intrapartum and neonatal single-dose nevirapine compared with zidovudine for prevention of mother-to-child transmission of human immunodeficiency virus-1 in Kampala, Uganda: 18-month follow-up of the HIVNET 012 randomised trial. Lancet 2003;362:859–863.CrossRefGoogle ScholarPubMed
The Petra study team. Efficacy of three short-course regimens of zidovudine and lamivudine in preventing early and late transmission of human immunodeficiency virus-1 from mother to child in Tanzania, South Africa, and Uganda (Petra study): a randomized, double-blind, placebo-controlled trial. Lancet 2002;359:1178–1186.CrossRef
Moodley, D., Moodley, J., Coovadia, H.et al., for the South African Intrapartum Nevirapine Trial (SAINT) Investigators. A multicenter randomized controlled trial of nevirapine versus a combination of zidovudine and lamivudine to reduce intrapartum and early postpartum mother-to-child transmission of human immunodeficiency virus type 1. J. Infect. Dis. 2003;187;725–735.CrossRefGoogle ScholarPubMed
Dorenbaum, A., Cunningham, C. K., Gelber, R. D.et al.Two-dose intrapartum/newborn nevirapine and standard antiretroviral therapy to reduce perinatal human immunodeficiency virus transmission: a randomized trial. J. Am. Med. Assoc. 2002;288:189–198.CrossRefGoogle ScholarPubMed
Lallemant, M., Jourdain, G., Coeur, S., et al.Single-dose perinatal nevirapine plus standard zidovudine to prevent Mother-to-child transmission of human immunodeficiency virus-1 in Thailand. N. Engl. J. Med. 2004;351:217–228.CrossRefGoogle ScholarPubMed
Sperling, R. S., Shapiro, D. E., Coombs, R. W.et al.Maternal viral load, zidovudine treatment, and the risk of transmission of human immunodeficiency virus type 1 from mother to infant. N. Engl. J. Med. 1996;335:1621–1629.CrossRefGoogle ScholarPubMed
Ioannidis, J. P. A., Abrams, E. J., Ammann, A.et al.Perinatal transmission of human immunodeficiency virus type 1 by pregnant women with ribonucleic acid virus loads <1000 copies/ml. J. Infect. Dis. 2001;183:539–545.CrossRefGoogle ScholarPubMed
Wade, N. A., Birkhead, G. S., Warren, B. L.et al.Abbreviated regimens of zidovudine prophylaxis and perinatal transmission of the human immunodeficiency virus. N. Engl. J. Med. 1998;339:1409–1414.CrossRefGoogle ScholarPubMed
Wade, N. A., Birkhead, G. S., French, P. T.Short courses of zidovudine and perinatal transmission of human immunodeficiency virus [letter]N. Engl. J. Med. 1999;340:1042–1043.Google Scholar
Chuachoowong, R., Shaffer, N., Siriwasin, W.et al.Short-course antenatal zidovudine reduces both cervicovaginal human immunodeficiency virus type 1 ribonucleic acid levels and risk of perinatal transmission. J. Infect. Dis. 2000;181:99–106.CrossRefGoogle ScholarPubMed
John, G. C., Nduati, R. W., Mbori-Ngacha, D. A.et al.Correlates of mother-to-child human immunodeficiency virus type 1 (human immunodeficiency virus-1) transmission: association with maternal plasma human immunodeficiency virus-1 ribonucleic acid load, genital human immunodeficiency virus-1 deoxyribonucleic acid shedding, and breast infections. J. Infect. Dis. 2001;182;206–212.CrossRefGoogle Scholar
Mandelbrot, L., Msellati, P., Meda, N.et al.15 month follow up of African children following vaginal cleansing with benzalkonium chloride of their human immunodeficiency virus infected mothers during late pregnancy and delivery. Sex. Transm. Infect. 2002;78:267–270.CrossRefGoogle ScholarPubMed
Biggar, R. J., Miotti, P. G., Taha, T. E.et al.Perinatal intervention trial in Africa: effect of a birth canal cleansing intervention to prevent human immunodeficiency virus transmission. Lancet 1996;347:1647–1650.CrossRefGoogle Scholar
Gaillard, P., Mwanyumba, F., Verhofstede, C.et al.Vaginal lavage with chlorhexidine during labor to reduce mother to child human immunodeficiency virus transmission: clinical trial in Mombasa, Kenya. acquired immune deficiency syndrome 2001;15:389–396.Google ScholarPubMed
Wilson, C., Gray, G., Read, J. S.et al.Tolerance and safety of different concentrations of chlorhexidine for peripartum vaginal and infant washes: HIVNET 025. J. Acquir. Immune Defic. Syndr 2004;35:138–143.CrossRefGoogle ScholarPubMed
Semba, R. D., Kumwenda, N., Hoover, D. R.et al.Human immunodeficiency virus load in breast milk, mastitis, and mother-to-child transmission of human immunodeficiency virus type 1. J. Infect. Dis. 1999;180:93–98.CrossRefGoogle ScholarPubMed
Richardson, B., Stewart-John, G. C., Hughes, J. P.et al.Breast-milk infectivity in human immunodeficiency virus type 1-infected mothers. J. Infect. Dis. 2003;187: 736–740.CrossRefGoogle ScholarPubMed
Nduati, R., Richardson, B. A., John, G.et al.Effect of breastfeeding on mortality among human immunodeficiency virus-1 infected women: a randomised trial. Lancet 2001;357:1651–1655.CrossRefGoogle ScholarPubMed
Coutsoudis, A., Coovadia, H., Pillay, K., Kuhn, L.Are human immunodeficiency virus-infected women who breastfeed at increased risk of mortality?acquired immune deficiency syndrome 2001;15:653–655.Google Scholar
The Breastfeeding and, International human immunodeficiency virus Transmission Study (BHITS) Group. Mortality according to infant feeding modality among human immunodeficiency virus-infected, breastfeeding women in sub-Saharan Africa. J. Acquir. Immune Defic. Syndr. 2005;39:430–438.CrossRef
Gaillard, P., Fowler, M. G., Dabis, F.et al.Use of antiretroviral drugs to prevent human immunodeficiency virus-1 transmission through breast-feeding: from animal studies to randomized clinical trials. J. Acquir. Immune Defic. Syndr. 2004; 35: 178–187.CrossRefGoogle ScholarPubMed
Krebs, F. C., Miller, S. R., Malamud, D., Howett, M. K., & Wigdahl, B.Inactivation of human immunodeficiency virus type 1 by nonoxynol-9, C31G, of an alkyl sulfate, sodium dodecyl sulfate. Antiviral Res. 1999;43:157–173.CrossRefGoogle ScholarPubMed
Chantry, C. J., Morrison, P., Panchula, J.et al.Effects of lipolysis or heat treatment on human immunodeficiency virus-1 provirus in breast milk. J. Acquir. Immune. Defic. Syndr. 2000; 24:325–329.CrossRefGoogle ScholarPubMed
Orloff, S. L., Wallingford, J. C., McDougal, J. S.Inactivation of human immunodeficiency virus type 1 in human milk: effects of intrinsic factors in human milk and of pasteurization. J. Hum. Lact. 1993;9:13–17.CrossRefGoogle ScholarPubMed
Jeffery, B. S., Webber, L., Mokhondo, K. R., Erasmus, D.Determination of the effectiveness of inactivation of human immunodeficiency virus by Pretoria pasteurization. J. Trop. Pediatr. 2001;47:345–349.CrossRefGoogle ScholarPubMed
The International Perinatal human immunodeficiency virus Group. Duration of ruptured membranes and vertical transmission of human immunodeficiency virus-1: a meta-analysis from fifteen prospective cohort studies. acquired immune deficiency syndrome 2001;15:357–368.
The International Perinatal human immunodeficiency virus Group. The mode of delivery and the risk of vertical transmission of human immunodeficiency virus type 1: a meta-analysis of 15 prospective cohort studies. N. Engl. J. Med. 1999;340:977–987.CrossRef
The European Mode of Delivery Collaboration. Elective caesarean section versus vaginal delivery in preventing vertical human immunodeficiency virus-1 transmission: a randomised clinical trial. Lancet 1999;353:1035–1037.CrossRef
The Breastfeeding and human immunodeficiency virus International Transmission Study Group. Late postnatal transmission of human immunodeficiency virus-1 in breast-fed childern: an individual patient data meta-analysis. J. Infect. Dis. 2004; 189: 2154–2166.CrossRef
Nduati, R., John, G., Mbori-Ngacha, D.et al.Effect of breastfeeding and formula feeding on transmission of human immunodeficiency virus-1: a randomized clinical trial. J. Am. Med. Assoc. 2000; 283:1167–1174.CrossRefGoogle ScholarPubMed
Piwoz, E. G., Kasonde, P., Vwalika, C. et al. The feasibility of early rapid breastfeeding cessation to reduce postnatal transmission of human immunodeficiency virus in Lusaka, Zambia. 14th International Conference on acquired immune deficiency syndrome (Barcelona, Spain; July 7–12, 2002), Program and Abstracts, abstract TuPeF5393.
Semba, R. D., Miotti, P. G., Chiphangwi, J. D.et al.Maternal vitamin A deficiency and mother-to-child transmission of human immunodeficiency virus-1. Lancet 1994;343:1593–1597.CrossRefGoogle Scholar
Kumwenda, N., Miotti, P. G., Taha, T. E.et al.Antenatal vitamin A supplementation increases birthweight and decreases anemia, but does not prevent human immunodeficiency virus transmission or decrease mortality in infants born to human immunodeficiency virus-infected women in Malawi. Clin. Infect. Dis. 2002;35:618–624.CrossRefGoogle ScholarPubMed
Coutsoudis, A., Pillay, K., Spooner, E.et al.Randomized trial testing the effect of vitamin A supplementation on pregnancy outcomes and early mother-to-child human immunodeficiency virus-1 transmission in Durban, South Africa. acquired immune deficiency syndrome 1999;13:1517–1524.Google ScholarPubMed
Fawzi, W. W., Msamanga, G. I., Hunter, D.et al.Randomized trial of vitamin supplements in relation to transmission of human immunodeficiency virus-1 through breastfeeding and early child mortality. acquired immune deficiency syndrome 2002;16:1935–1944.Google ScholarPubMed
Louis, M.St., Kamenga, M., Brown, C.et al.Risk of perinatal human immunodeficiency virus-1 transmission according to maternal immunologic, virologic, and placental factors. J. Am. Med. Assoc. 1993;269:2853–2859.CrossRefGoogle Scholar
Temmerman, M., O'Nyong's, A., , Bwayo J.et al.Risk factors for mother-to-child transmission of human immunodeficiency virus-1 infection. Am. J. Obstet. Gynecol. 1995;172:700–705.CrossRefGoogle ScholarPubMed
Wabwire-Mangen, F., Gray, R. H., Mmiro, F. A.et al.Placental membrane inflammation and risks of maternal-to-child transmission of human immunodeficiency virus-1 in Uganda. acquired immune deficiency syndrome 1999;22:379–385.CrossRefGoogle ScholarPubMed
Kafulafula, G., Martinson, F., Msamanga, G., Sinkala, M., and the HIVNET 024 Team Phase III Trial of Antibiotics to Reduce Chorioamnionitis-Associated mother-to-child transmission of human immunodeficiency virus. XV International acquired immune deficiency syndrome Conference (Bangkok, Thailand; July 11–16, 2004) Program and Abstracts (abstract ThOrC1418).
Coutsoudis, A., Pillay, K., Kuhn, L., Spooner, E., Tsai, W. Y., Coovadia, H. M.Method of feeding and transmission of human immunodeficiency virus-1 from mothers to children by 15 months of age: prospective cohort study from Durban, South Africa. acquired immune deficiency syndrome 2001;15:379–387.Google ScholarPubMed
I1iff, P. J., Piwoz, E. G., Tavengwa, N. V.et al.Early exclusive breastfeeding reduces the risk of postnatal human immunodeficiency virus-1 transmission and increases human immunodeficiency virus-free survival. acquired immune deficiency syndrome. 2005; 19(7):699–708.Google Scholar
Haider, R., Ashworth, A., Kabir, I., Huttly, S. R.Effect of community-based peer counsellors on exclusive breastfeeding practices in Dhaka, Bangladesh: a randomised controlled trial. Lancet 2000;356:1643–1647.CrossRefGoogle ScholarPubMed
Perre, P., Hitimana, D. G., Simonon, A.et al.Postnatal transmission of human immunodeficiency virus-1 associated with breast abscess. Lancet 1992;339:1490–1491.CrossRefGoogle ScholarPubMed
Ekpini, E. R., Wiktor, S. Z., Satten, G. A.et al.Late postnatal mother-to-child transmission of human immunodeficiency virus-1 in Abidjan, Côte d'Ivoire. Lancet 1997;349:1054–1059.CrossRefGoogle ScholarPubMed
Embree, J. E., Njenga, S., Datta, P.et al.Risk factors for postnatal mother-child transmission of human immunodeficiency virus-1. acquired immune deficiency syndrome 2000;14:2535–2541.Google Scholar
Tavengwa, N., Piwoz, E., Gavin, L., Zunguza, C., Iliff, P., Humphrey, J. Development, implementation, and evaluation of a program to counsel women about infant feeding in the context of human immunodeficiency virus. 14th International Conference on acquired immune deficiency syndrome (Barcelona, Spain; July 7–12, 2002), Program and Abstracts, abstract MoPeF3881.
UNAIDS. 2004 Report on the Global acquired immune deficiency syndrome epidemic. (http://www.unaids.org)
Read, J. S.Preventing mother-to-child transmission of human immunodeficiency virus: the USA experience. Prenat. Neonat. Med. 1999;4:391–397.Google Scholar
Centers for Disease Control and Prevention. U. S. Public Health Service recommendations for human immunodeficiency virus counseling and voluntary testing for pregnant women. Morb. Mortal. Wkly Rep. 1995;44 (relative risk-7):1–15.
Lindegren, M. L., Byers, R. H. Jr, Thomas, P.et al.Trends in perinatal transmission of human immunodeficiency virus/acquired immune deficiency syndrome in the United States. J. Am. Med. Assoc. 1999;282:531–538.CrossRefGoogle Scholar
Centers for Disease Control and Prevention. Entry into prenatal care – United States, 1989–1997. Morb. Mortal. Wkly Rep. 2000;49 (18):393–398.
Mills, W. A., Martin, D. L., Bertrand, J. R., Belongia, E. A.Physicians' practices and opinions regarding prenatal screening for human immunodeficiency virus and other sexually transmitted diseases. Sex. Transm. Dis. 1998;25:169–175.CrossRefGoogle ScholarPubMed
, Phillips K A, , Morrison K R, , Sonnad S S, , Bleecker T.human immunodeficiency virus counseling and testing of pregnant women and women of childbearing age by primary care providers: self-reported beliefs and practices. Acquir. Immune Defic. Hum. Retrovirol. 1997;14:174–178.CrossRefGoogle Scholar
Institute of Medicine (IOM). (1998) Reducing the Odds: Preventing Perinatal Transmission of human immunodeficiency virus in the United States. Washington, dendritic cells: National Academy Press.
Centers for Disease Control and Prevention. Advancing human immunodeficiency virus prevention: new strategies for a changing epidemic – United States, 2003. Morb. Mortal. Wkly Rep. 2003;52 (15):329–332.
Cartoux, M., Msellati, P., Meda, N.et al.Attitude of pregnant women toward human immunodeficiency virus testing in Abidjan, Cote d'Ivoire and Bobo-Dioulasso, Burkina Faso. acquired immune deficiency syndrome 1998;12:2337–2344.Google Scholar
Centers for Disease Control. Current recommendations for assisting in the prevention of perinatal transmission of human T-lymphotropic virus type III/lymphadenopathy-associated virus and acquired immunodeficiency syndrome. Morb. Mortal. Wkly Rep. 1985;34:721–726.
American Academy of Pediatrics, Committee on Pediatric acquired immune deficiency syndrome. Human milk, breastfeeding, and transmission of human immunodeficiency virus in the United States. Pediatrics. 1995;96:977–979.
Read, J. S., and the Committee on Pediatric acquired immune deficiency syndrome, American Academy of Pediatrics. Human milk, breastfeeding, and transmission of human immunodeficiency virus in the United States. Pediatrics 2003;112:1196–1205.CrossRefGoogle Scholar
Bertolli, J. M., Hsu, H., Frederick, T. et al. Breastfeeding among human immunodeficiency virus-infected women, Los Angeles and Massachusetts, 1988–1993. 11th World acquired immune deficiency syndrome Conference, Vancouver, 1996. Abstract We.C.3583.
Simonds, R. J., Steketee, R., Nesheim, S.et al.Impact of zidovudine use on risk and risk factors for perinatal transmission of human immunodeficiency virus. acquired immune deficiency syndrome 1998;12:301–308.Google Scholar
Mbori-Ngacha, D., Nduati, R., John, G.et al.Morbidity and mortality in breastfed and formula-fed infants of human immunodeficiency virus-1-infected women: a randomized clinical trial. J. Am. Med. Assoc. 2001;286:2413–2420.CrossRefGoogle Scholar
World Health Organization. Report of the World Health Organization Technical Consultation on Behalf of the UNFPA/UNICEF/WHO/UNAIDS Inter-Agency Task Team on Mother-to-Child Transmission of human immunodeficiency virus, October 11–13, 2000. New data on the prevention of mother-to-child transmission of human immunodeficiency virus and their policy implications. Geneva, Switzerland: World Health Organization; January 15, 2001. (Available at www.unaids.org/publications/documents/mtct/index.html).
American College of Obstetricians and Gynecologists. Scheduled cesarean delivery and the prevention of vertical transmission of human immunodeficiency virus infection. American College of Obstetricians and Gynecologists Committee Opinion Number 234. Washington, D. C.: American College of Obstetricians and Gynecologists, May 2000.
Centers for Disease Control and Prevention. US Public Health Service Task Force recommendations for the use of antiretroviral drugs in pregnant women infected with human immunodeficiency virus-1 for maternal health and for reducing perinatal human immunodeficiency virus-1 transmission in the United States. MMWR 1998;47 (No. relative risk-2): 1–30. (Most recent revision of the guidelines available at http://AIDSInfo.nih.gov.).
Dominguez, K. L., Lindegren, M. L., D'Almada, P. J.et al.Increasing trend of Cesarean deliveries in human immunodeficiency virus-infected women in the United States from 1994 to 2000. J. Acquir. Immune Defic. Syndr. 2003;33:232–238.CrossRefGoogle Scholar
Shaffer, N., Roongpisuthipong, A., Siriwasin, W.et al.Maternal viral load and perinatal human immunodeficiency virus-1 subtype E transmission, Thailand. J. Infect. Dis. 1999;179:590–599.CrossRefGoogle Scholar
The European Collaborative Study. Maternal viral load and vertical transmission of human immunodeficiency virus-1: an important factor but not the only one. acquired immune deficiency syndrome 1999;13:1377–1385.
Fiscus, S., Adimora, A, Schoenbach et al. Elective c-section may provide additional benefit in conjunction with maternal combination antiretroviral therapy to reduce perinatal human immunodeficiency virus transmission. XIII World acquired immune deficiency syndrome Conference (July 2000, Durban, South Africa), Abstract WePpC1388.
European Collaborative Study. Mother-to-child transmission of human immunodeficiency virus infection: the era of highly active antiretroviral therapy. Clin. Infect. Dis. 2005;40:458–465.CrossRef
Mrus, J. M., Goldie, S. J., Weinstein, M. C., Tsevat, J.The cost-effectiveness of elective Cesarean delivery for human immunodeficiency virus-infected women with detectable human immunodeficiency virus ribonucleic acid during pregnancy. acquired immune deficiency syndrome 2000;14:2543–2552.Google Scholar
Read, J. S., Cesarean section delivery to prevent vertical transmission of human immunodeficiency virus type 1: associated risks and other considerations. Ann. NY Acad. Sci. 2000;918:115–121.CrossRefGoogle ScholarPubMed
Read, J. S., Preventing mother to child transmission of human immunodeficiency virus: the role of caesarean section. Sex. Transm. Infect. 2000;76:231–232.CrossRefGoogle ScholarPubMed
Ippolito, G., Puro, V., Heptonstall, J., Jagger, J., Carli, G., Petrosillo, N.Occupational human immunodeficiency virus infection in health care workers: worldwide cases through September 1997. Clin. Infect. Dis. 1999;28:365–383.CrossRefGoogle ScholarPubMed
Center for Disease Control and Prevention. Recommendations of the US Public Health Service Task Force on the use of zidovudine to reduce perinatal transmission of human immunodeficiency virus. Morb. Mortal Wkly Rep. 1994;43 (relative risk11):1–20.
Centers for Disease Control and Prevention. Guidelines for the use of antiretroviral agents in human immunodeficiency virus-infected adults and adolescents. MMWR 1998;47: 47 (No. relative risk-5) 43–82 (updates available at http://AIDSInfo.nih.gov).
Lyall, E. G. H., Blott, M., Ruiter, A.et al.Guidelines for the management of human immunodeficiency virus infection in pregnant women and the prevention of mother-to-child transmission. human immunodeficiency virus Med. 2001;2:314–334.Google ScholarPubMed
Newell, M.-L., Rogers, M.Pregnancy and human immunodeficiency virus infection: a European Consensus on management. acquired immune deficiency syndrome 2002;16 (Suppl. 2):S1–S18.Google Scholar
World Health Organization. Scaling up antiretroviral therapy in resource-limited settings: treatment guidelines for a public health approach (2003 revision). (http://www.who.int/3by5/publications/documents/arv_guidelines/en).
Mofenson, L. M., Munderi, P.Safety of antiretroviral prophylaxis of perinatal transmission for human immunodeficiency virus-infected pregnant women and their infants. acquired immune deficiency syndrome 2002;30:200–215.CrossRefGoogle Scholar
Nolan, M., Fowler, M. G., Mofenson, L. M.Antiretroviral prophylaxis of perinatal human immunodeficiency virus-1 transmission and the potential impact of antiretroviral resistance. acquired immune deficiency syndrome 2002;30:216–229.CrossRefGoogle ScholarPubMed
Jourdain, G., Ngo-Giang-Huong, N., Coeur, S., et al.Intrapartum exposure to neivrapine and subsequent maternal responses to nevirapine-base antiretroviral therapy. N. Engl. J. Med. 2004;351:229–240.CrossRefGoogle Scholar
Lockman, S., Smeaton, L. M., Shapiro, R. L. et al. Maternal and infant response to nevirapine (NVP)-based antiretroviral treatment (antiretroviral therapy) following peripartum single-does NVP or placebo (Plc.) Program and Abstracts of the 43rd Annual Meeting of IDSA (San Francisco; October 6–9, 2005); abstract LB-5.
Hirsch, M. S., Brun-Vézinet, F., Clotet, B.et al.Antiretroviral drug resistance testing in adults infected with human immunodeficiency virus type 1: 2003 recommendations of an International acquired immune deficiency syndrome Society-USA panel. Clin. Infect. Dis. 2003;37:113–128.CrossRefGoogle Scholar
The EuroGuidelines Group for human immunodeficiency virus Resistance. Clinical and laboratory guidelines for the use of human immunodeficiency virus-1 drug resistance testing as part of treatment management: recommendations for the European setting. acquired immune deficiency syndrome 2001;15:309–320.
Johnson, V. A., Petropoulos, C. J., Woods, C. R.et al.Vertical transmission of multi-drug resistance human immunodeficiency virus type 1 (human immunodeficiency virus-1) and continued evolution of drug resistance in an human immunodeficiency virus-1-infected infant. J. Infect. Dis. 2001;183:1688–1693.CrossRefGoogle Scholar
Guay, L. A., Musoke, P., Hom, D. L.et al.Phase I/II trial of human immunodeficiency virus-1 hyperimmune globulin for the prevention of human immunodeficiency virus-1 vertical transmission in Uganda. acquired immune deficiency syndrome 2002;16:1391–1400.Google ScholarPubMed
Biberfeld, G., Buonaguro, F., Lindberg, A., The, G., Yi, Z., Zetterstrom, R.Prospects of vaccination as a means of preventing mother-to-child transmission of human immunodeficiency virus-1. Acta Paediatr. 2002;91:241–242.CrossRefGoogle Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×