Prevention of vertical transmission of HIV-1 in resource-limited settings

Abstract

One of the most exciting areas of HIV research is that of prevention of vertical transmission from mother to child, since it accounts for 90% of childhood HIV infections, and therefore prevention in this context has an enormous potential impact on the spread of HIV among children. Focused research has yielded highly successful strategies for reducing infant infection rates, particularly in the developed world, and much work is underway to implement appropriate strategies in resource-limited settings, although this is not without challenges. Although transmission rates in some settings have been reduced to approximately 1%, scale-up and widespread implementation and application of strategic interventions for prevention of mother-to-child transmission of HIV during pregnancy, delivery and breastfeeding are needed in the developing world.

Keywords::

• antiretroviral therapy
• breastfeeding interventions
• drug safety
• HIV
• PMTCT
• post-exposure prophylaxis
• resistance
• resource-limited setting
• vertical transmission

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Notes

^†EFV-based regimens should not be newly initiated in the first trimester.

3TC: Lamivudine; ABC: Abacavir; ARV: Antiretroviral; AZT: Zidovudine; EFV: Efavirenz; FTC: Emtricitabine; NVP: Nevirapine; TDF: Tenofovir.

Data taken from [201].