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Curr Opin Pediatr. 2009 Feb;21(1):94-101. doi: 10.1097/MOP.0b013e32831ec353.

Update on successes and challenges regarding mother-to-child transmission of HIV.

Author information

1
Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut 06520-8064, USA. Elijah.paintsil@yale.edu

Abstract

PURPOSE OF REVIEW:

There is an unprecedented global commitment to reverse the pediatric HIV epidemic by making prevention of mother-to-child transmission (PMTCT) services accessible in all countries. This review outlines the successes made and the challenges that remain.

RECENT FINDINGS:

In resource-rich countries, mother-to-child transmission rates of HIV as low as 1% have been achieved. The efficacy of short-course antiretrovirals for PMTCT in Africa is estimated at 50%. Coinfections with herpes simplex virus type 2, other sexually transmitted infections resulting in genital ulcers, and endemic infectious diseases (e.g., malaria) may increase the risk of mother-to-child transmission of HIV. Vertical transmission of drug-resistant viruses has been reported; the prevalence and effect of transmitted resistant virus on treatment outcomes are under investigation. Obstacles facing PMTCT in resource-limited countries include the lack of healthcare infrastructure, limited manpower, and competing public health priorities with the limited healthcare budget.

SUMMARY:

Although the birth of an HIV-infected child in a resource-rich country is now a sentinel health event, in most resource-limited countries the birth of an HIV-infected child continues to be the status quo. Comprehensive PMTCT, including antiretroviral treatment for HIV-infected women and children, should be paramount in resource-limited countries.

PMID:
19242245
PMCID:
PMC2650837
DOI:
10.1097/MOP.0b013e32831ec353
[Indexed for MEDLINE]
Free PMC Article

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