Article Abstract:
Factors relating to maternal-child HIV transmission include maternal viral load, viral strain, maternal antibody titers, and infection with other sexually transmitted diseases. Labor and delivery events also play a role in the likelihood of transmission. Zidovudine treatment in pregnancy, formula feeding, avoidance of invasive procedures such as amniocentesis or using fetal scalp electrodes, and treatment of sexually transmitted disease help prevent maternal-child HIV transmission. Only 40% of infants can be accurately identified as infected in the first week, rising to 90% or more by one month. Children are more likely to have rapid progression to AIDS than adults. Unlike adults, the CD4 count is not a reliable indicator for when to begin preventative treatment for P. carinii pneumonia. Therefore, all infants of HIV-infected mothers should be treated until HIV status is established. Infants should receive routine immunizations, and the killed poliovirus vaccine is recommended.
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Article Abstract:
Results from the AIDS Clinical Trials Group (ACTG) 076 study indicate that zidovudine given during the brief time around labor and delivery may substantially reduce the chances that an HIV-infected mother will transmit the virus to her infant. Several studies have shown this, but the ACTG 076 study revealed that zidovudine reduced transmission rates even though it did not significantly lower viral counts. It is possible that suppressing viral reproduction during delivery may be all that is needed. If so, the 6 million HIV-infected pregnant women in developing countries could be easily treated.
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Article Abstract:
A shorter treatment period for mother and baby may not prevent the transmission of HIV from an HIV-infected pregnant woman to her baby. This will make the treatment of HIV infection in women challenging in developing countries that cannot afford long treatment periods.
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