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Human Immunodeficiency Virus...

PEDIATRICS Vol. 106 No. 6 December 2000, p. e88

ELECTRONIC ARTICLE:
Technical Report: Perinatal Human Immunodeficiency Virus Testing and Prevention of Transmission

Lynne M. Mofenson and the Committee on Pediatric AIDS

In 1994, the US Public Health Service published guidelines for the use of zidovudine to decrease the risk of perinatal transmission of human immunodeficiency virus (HIV). In 1995, the American Academy of Pediatrics and the US Public Health Service recommended documented, routine HIV education and testing with consent for all pregnant women in the United States. Widespread incorporation of these guidelines into clinical practice has resulted in a dramatic decrease in the rate of perinatal HIV transmission and has contributed to more than a 75% decrease in reported cases of pediatric acquired immunodeficiency syndrome (AIDS) since 1992. Substantial advances have been made in the treatment and monitoring of HIV infection; combination antiretroviral regimens that maximally suppress virus replication are now available. These regimens are recommended for pregnant and nonpregnant individuals who require treatment. Risk factors associated with perinatal HIV transmission are now better understood, and recent results from trials to decrease the rate of mother-to-child HIV transmission have contributed new strategies with established efficacy. However, perinatal HIV transmission still occurs; the Centers for Disease Control and Prevention estimates that 300 to 400 infected infants are born annually. Full implementation of recommendations for universal, routine prenatal HIV testing and evaluation of missed prevention opportunities will be critical to further decrease the incidence of pediatric HIV infection in the United States. This technical report summarizes recent advances in the prevention of perinatal transmission of HIV relevant to screening of pregnant women and their infants.

 Key words:  perinatal transmission, human immunodeficiency virus, prenatal testing, antiretroviral prophylaxis.


The following policy statement is a revision:

HIV Testing and Prophylaxis to Prevent Mother-to-Child Transmission in the United States

Pediatrics 122: 1127-1134. [Full Text]



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