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

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

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.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Adult
  • Anti-Retroviral Agents / therapeutic use
  • Child
  • Child, Preschool
  • Comorbidity
  • Developed Countries
  • Developing Countries
  • Drug Resistance, Viral
  • Female
  • Global Health
  • HIV Infections / epidemiology
  • HIV Infections / prevention & control*
  • HIV Infections / transmission*
  • Health Services Accessibility / organization & administration
  • Humans
  • Infant
  • Infant, Newborn
  • Infectious Disease Transmission, Vertical / prevention & control*
  • Mother-Child Relations
  • Practice Guidelines as Topic
  • Pregnancy
  • Pregnancy Complications, Infectious / prevention & control
  • Preventive Health Services / methods
  • Preventive Health Services / organization & administration
  • Risk Factors
  • Treatment Outcome

Substances

  • Anti-Retroviral Agents