Strategies for prevention of perinatal transmission of HIV infection: Siena Consensus Workshop II

Article Abstract:

There are many interventions that may reduce the transmission of HIV from a pregnant woman to her baby before, during and after birth. From 14% to 39% of HIV-infected pregnant women will pass the infection to their baby. The World Health Organization estimates that 10 million babies will be born HIV-infected by the year 2000. Many risk factors for perinatal transmission are known, including the mother's disease stage, whether she has other sexually transmitted diseases and whether her placental membranes rupture prematurely. Transmission may occur most often during childbirth. It may be possible to reduce this risk by washing the birth canal and the baby or delivering the baby by cesarean section. The mother can also take antiviral drugs during pregnancy. Passive and active immunization using antibodies and vaccines may reduce transmission rates. Women in developing countries as well as those in industrialized countries should be recruited for trials to test these interventions.

Prevention

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Rates of mother-to-child transmission of HIV-1 in Africa, America, and Europe: results from 13 perinatal studies

Article Abstract:

Two different methods for calculating the rate at which pregnant HIV-infected women transmit the virus to their babies appear to produce similar results and they reveal that the transmission rate is higher in developing countries. Researchers tracking transmission rates in 13 studies worldwide met in Belgium in 1993 to compare results. Some researchers used the direct method of estimating transmission rates, which relies on persistent antibodies against HIV in the newborn baby, death from a complication of HIV infection or a diagnosis of AIDS. Others used the indirect method, which counts persistent HIV antibodies and the excess death in babies of HIV-infected women compared to babies of non-infected women. The indirect method produced values close to the intermediate estimates of the direct method, and both revealed transmission rates of 14% to 25% in developed countries and 25% to 30% in developing countries.

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A prospective study of mother-to-infant HIV transmission in tribal women from India

Article Abstract:

The most likely routes of transmission of HIV type 1 from mother to child may be through the placenta or fluids during late pregnancy or birth. Researchers studied 160 HIV-positive women from low-income villages in India who became pregnant. The overall HIV transmission rate from mother to infant was 48%. Transmission risk factors were mothers who showed symptoms of HIV, low maternal CD4+ cell count, preterm delivery, and low birth weight. HIV was determined to have been transmitted via the placenta in 4% of cases. Seventy-four of 137 infants born to asymptomatic mothers did not become HIV-positive. Mothers breastfed their infants after birth, but breastfeeding did not appear to transmit HIV. Breastfeeding by asymptomatic HIV-positive mothers appears to be safe.

Health aspects, Risk factors, Breast feeding

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