Current HIV research

Publications in this journal

• Article: HAART Has No Major Impact on Hematological and Plasma Bilirubin Changes in HIV-Infected Patients with Congenital G-6-PD Deficiency.

  Sakorn Pornprasert, Auttapon Panya, Chalisa Louicharoen Cheepsunthorn, Sarinee Srithep, Doungnapa Kingkeow
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  ABSTRACT: Hematological effects of antiretroviral (ARV) drugs in HIV-infected patients with glucose-6-phosphate dehydrogenase (G-6-PD) deficiency are unclear. The aim of this study was to assess effects of highly active antiretroviral therapy (HAART) on hematological and plasma bilirubin changes in these patients. A hundred and nine HIV-infected Thai patients were tested for G-6-PD deficiency and its variant by using fluorescent spot test and polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis, accordingly. Changes of hematological parameters and plasma bilirubin at baseline and 6 months of HAART were analyzed in G-6-PD deficiency patients. G-6-PD deficiency was found in 10 (9.17%) patients and G-6-PD Canton1376G>T was the most frequent. Of these, 3 patients were coinheritance of G-6-PD deficiency and thalassemia. Increased mean levels of lymphocyte counts, CD4+ T-cells, mean corpuscular hemoglobin (MCH) and hemoglobin from baseline to 6 months of HAART were observed. Whereas, mean levels of total bilirubin and direct bilirubin at baseline were not significantly different from those at 6 months of HAART. Therefore, HAART did not cause hemolytic anemia and hyperbilirubinemia in HIV-infected patients with G-6-PD deficiency. On the other hand, the effective use of HAART is associated with improvements in hemoglobin and MCH levels of these patients.
  Current HIV research 05/2013;
• Article: Effects of Antiretroviral Drugs for Prevention of HIV-Mother-to-Child Transmission on Hematological Parameters and Hemoglobin Synthesis in HIV-Uninfected Newborns With and Without Thalassemia Carrier.

  Rotjanee Wongnoi, Peninnah Oberdorfer, Pannee Sirivatanapa, Chotiros Phanpong, Sakorn Pornprasert
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  ABSTRACT: The effects of antiretroviral (ARV) drugs administered to HIV-infected pregnancy on hematological parameters and hemoglobin (Hb) synthesis in ARV-exposed newborns with and without thalassemia carrier and of ARV drugs in worsening anemia in thalassemia carrier newborns are not well understood. Cord blood samples were collected from newborns of HIV-infected and -uninfected pregnancies. Hematological parameters and hemoglobin typing were analyzed by automated blood counter and capillary electrophoresis (CE), respectively. In the group of thalassemia carrier, the ARV-exposed newborns had significantly lower mean levels of red blood cell counts and hematocrit and had significantly higher mean levels of MCH than the ARV-unexposed newborns. Similar results were found in the group of newborns without thalassemia carrier. There were no statistically differences in mean levels of Hb-A2, Hb-A, Hb-F and Hb-E (when applicable) in ARV-exposed and -unexposed newborns either with or without thalassemia carrier. However, ARV-exposed newborns who were thalassemia carrier had the lowest levels of hemoglobin and hematocrit when compared to the other groups. Therefore, ARV drugs used for prevention of HIV-mother-to-child transmission (HIV-MTCT) alter hematological parameters but did not affect hemoglobin synthesis in newborns with and without thalassemia carrier. However, thalassemia and ARV drugs might have synergetic effect in inducing severe anemia.
  Current HIV research 04/2013;
• Article: Long-Term Gender-Based Outcomes for Atazanavir/Ritonavir (ATV/r) - Containing Regimens in Treatment-Experienced Patients with HIV.

  V Svedhem-Johansson, P Pugliese, N H Brockmeyer, A Thalme, C Michalik, S Esser, M H Barlet, T Nakonz, M J Jimenez-Exposito
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  ABSTRACT: Clinical data on antiretroviral effectiveness in women is limited, especially long-term data, because women are usually underrepresented in clinical trials. This sub-analysis of a large European non-comparative, retrospective, observational cohort study evaluated gender differences in long-term outcomes in antiretroviral-experienced adult patients with HIV-1 infection switched to an ATV/r-based regimen between October 2004 and March 2007. Data were extracted from 3 European HIV databases every 6 months (maximum follow-up 5 years). Time to virological failure (VF), defined as two consecutive HIV-1 RNA ≥50 c/mL or one HIV-1 RNA ≥50 c/mL followed by treatment discontinuation (TD), and time to TD were analyzed using the Kaplan-Meier method. Associations of gender with VF and TD were analyzed using multivariate Cox proportional models. Safety and tolerability were evaluated. In total, 1294 patients (336 women, 958 men) were analyzed. No gender differences in time to VF were observed; at 3 years, the probability of not having VF was 0.59 (95%CI: 0.52, 0.65) and 0.63 (95%CI: 0.59, 0.67) for women and men, respectively. In multivariate analyses, women had a higher risk of TD than men (hazard ratio [HR], 1.54; 95%CI: 1.28, 1.85) but no increased risk of VF (HR, 1.06; 95%CI: 0.85, 1.33). Safety and tolerability were comparable between genders. In a clinical setting, long-term efficacy and safety outcomes of ATV/r-based regimens were similar by gender. Women had a higher risk of TD but no increased risk of VF. ATV/r is an effective and well-tolerated therapeutic option for treatment-experienced men and women with HIV-1 infection.
  Current HIV research 04/2013;
• Article: Frequency of Depression and it's Correlation with Serum Carnitine Level in HIV/AIDS Patients.

  Haleh Rezaee, Hossein Khalili, Shima Hatamkhani, Simin Dashti-Khavidaki, Zahra Khazaeipour
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  ABSTRACT: There are some evidences regarding the beneficial effects of carnitine in depressive disorders. Carnitine deficiency is prevalent in HIV positive individuals. Also incidence of depression is significantly higher among the HIV positive individuals compared to HIV negative populations. In a cross-sectional study correlation between serum total carinitine level and depression score based on Beck Depression Inventory questionnaire was assessed in 100 HIV/AIDS (42 males and 58 females) individuals. According to Beck Depression Inventory definitions, 31%, 16% and 21% of the patients experienced mild, moderate and severe level of depression respectively. The mean ±SD serum concentration of total carnitine in the patients was 37.96±26.08 (μmol/L). Fifty-four (54%) of the patients were categorized as carnitine deficient. A non-statistically significant negative correlation between patients' depression scores and total levels of serum carnitine was found. Considering the prevalence of depression among HIV/AIDS patients and probable role of carnitine in pathogenesis of depressive disorders, more studies are needed to reveal any relationship between depression and body storage of carnitine.
  Current HIV research 04/2013;
• Article: Herpetic (Non-Cytomegalovirus) Retinal Infections In Patients With The Acquired Immunodeficiency Syndrome.

  Michael W Stewart
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  ABSTRACT: Human herpes viruses cause significant morbidity in patients with the acquired immunodeficiency syndrome. Even after the introduction of highly active anti-retroviral therapy (HAART), herpes viruses remain the leading causes of blindness in AIDS patients. Cytomegalovirus (CMV) retinitis and the closely-related immune reconstitution uveitis syndrome are the most common causes of blindness, but progressive outer retinal necrosis and acute retinal necrosis due to varicella zoster and herpes simplex are also important causes of vision loss. Successful treatment of these conditions requires an aggressive approach with multi-drug intravenous therapy or repeated intravitreal antiviral injections. Since the rate of retinal detachment is alarmingly high despite successful antiviral therapy, internists and ophthalmologists must work closely together to recognize and treat complications as they arise. Fortunately, Epstein-Barr virus is a rare cause of retinal infection and human herpes virus (HHV)-6, HHV-7, and HHV-8 do not appear to be primary pathogens. However, increasing evidence suggests that HHV-6 and HHV-7 play important roles in modulating the immune system and potentiating infection by CMV.
  Current HIV research 04/2013;
• Article: Prevention of Mother-to-Child Transmission of HIV in Low and Middle-Income Countries.

  Avinash K Shetty
  Current HIV research 02/2013;
• Article: Antiretroviral Drugs to Prevent Mother-to-Child Transmission of HIV during Breastfeeding.

  Avinash K Shetty, Yvonne Maldonado
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  ABSTRACT: In low and middle-income countries (LMIC), transmission of HIV during breastfeeding represents a major public health challenge. In the absence of interventions, breast milk HIV transmission can account up to 40% or more of new pediatric HIV infections in sub Saharan Africa. Several viral, maternal clinical, immunological and genetic factors, as well as maternal-infant host factors and type of infant feeding may influence the risk of breastfeeding transmission of HIV. The mechanisms of breast milk HIV transmission are poorly understood. For mothers who are healthy and do not need combination antiretroviral therapy for their own health, randomized controlled trials have proven that administration of extended maternal triple-drug antiretroviral (ARV) prophylaxis or extended infant ARV prophylaxis can significantly reduce the risk of HIV transmission during breastfeeding. Based on this evidence, the World Health Organization (WHO) published new guidance in 2010 on the use of ARVs for treating pregnant women, and preventing mother-to-child HIV transmission (PMTCT). Although, remarkable advances have occurred in prevention of postnatal transmission during breastfeeding using antiretroviral strategies, a number of challenges remain. Future research must focus on field studies to evaluate programmatic implementation of new WHO PMTCT regimens, monitor long-term safety of ART exposure during pregnancy and lactation, and study emergence of ARV resistance (in mothers and infected infants despite prophylaxis).
  Current HIV research 02/2013;
• Article: Reproductive Health and Family Planning Needs among HIV-Infected Women in Sub-Saharan Africa.

  Clea C Sarnquist, Lisa Rahangdale, Yvonne Maldonado
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  ABSTRACT: Objective: Review key topics and recent literature regarding reproductive health and family planning needs for HIV-infected women in sub-Saharan Africa. Methods: Electronic searches performed in Pubmed, JSTOR, and Web of Science; identified articles reviewed for inclusion. Findings: Most HIV-infected women in sub-Saharan Africa bear children, and access to antiretroviral therapy may increase childbearing desires and/or fertility, resulting in greater need for contraception. Most contraceptive options can be safely and effectively used by HIV-infected women. Unmet need for contraception is high in this population, with 66-92% of women reporting not wanting another child (now or ever), but only 20-43% using contraception. During pregnancy and delivery, HIV-infected women need access to prevention of mother to child transmission (PMTCT) services, a skilled birth attendant, and quality post-partum care to prevent HIV infection in the infant and maximize maternal health. Providers may lack resources as well as appropriate training and support to provide such services to women with HIV. Innovations in biomedical and behavioral interventions may improve reproductive healthcare for HIV infected women, but in sub-Saharan Africa, models of integrating HIV and PMTCT services with family planning and reproductive health services will be important to improve reproductive outcomes. Conclusions: HIV-infected women in sub-Saharan Africa have myriad needs related to reproductive health, including access to high-quality family planning information and options, high-quality pregnancy care, and trained providers. Integrated services that help prevent unintended pregnancy and optimize maternal and infant health before, during and after pregnancy will both maximize limited resources as well as provide improved reproductive outcomes.
  Current HIV research 02/2013;
• Article: Male Involvement and Prevention of Mother to Child Transmission of HIV in Sub-Saharan Africa: An Integrative Review.

  Jaana Auvinen, Jari Kylmä, Tarja Suominen
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  ABSTRACT: Purpose: The purpose of the study was to describe male involvement in programmes for preventing mother to child transmission (PMTCT) in sub-Saharan Africa. The study questions guiding this review were: how are male partners involved in PMTCT programmes in sub-Saharan Africa and what are the strategies for improvement of male involvement? Methods: An integrative review was conducted based on the data retrieved from the PubMed MEDLINE database. In all, 18 articles were included in this review. Qualitative content analysis was used as a method of data synthesis. Findings: Based on the findings of this review, some studies suggested that men had positive attitudes towards PMTCT programmes. However, also barriers to male involvement were identified. These barriers included negative attitude, lack of resources, fear of human immunodeficiency virus (HIV) test result, marital difficulties, problems with health care services and cultural barriers. Accepting HIV testing was associated with factors related to both wife and husband. Strategies for improving male involvement included ones that focus on men's and their wives' resources (sensitizing men about antenatal care (ANC) and PMTCT, focusing on the conjugal context and couples counseling), the development of health care services (tailoring the services to male needs, taking care of health care staff's resources, developing health care strategies) and the community (educating the community, testing, safer infant feeding). Implications: We should highlight the male participation in PMTCT programmes. However, more research is needed in order to evaluate their impact on PMTCT, as well as on broader family health outcomes.
  Current HIV research 02/2013;
• Article: Epidemiology of HIV Infection in Women and Children: A Global Perspective.

  Avinash K Shetty
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  ABSTRACT: The global epidemiology of HIV/AIDS is rapidly evolving in low and middle income countries. Women and adolescent females in sub-Saharan Africa are at risk of HIV acquisition due to a myriad of complex biological, behavioral and structural factors. Primary HIV infection among women primarily drives the pediatric HIV epidemic. Postnatal transmission of HIV during breastfeeding is a major concern in LMIC, particularly in sub-Saharan Africa where breastfeeding remains the only feasible, safe and culturally acceptable infant feeding choice. Given the remarkable discoveries in biomedical interventions to prevent sexual transmission of HIV and MTCT during breastfeeding, there is now a unique opportunity to rapidly implement combination HIV prevention packages, provide quality prevention of mother-to-child HIV transmission services, and improve maternal and infant survival. Although rapid scale-up of PMTCT interventions has occurred in sub Saharan Africa in the past five years, significant challenges remain towards reaching the ambitious goal of virtual elimination of new HIV infections among children on a global scale by 2015 and keeping their mothers alive. Rapid translation of scientific discoveries into policy and practice in conjunction with strong commitment from national leadership and global partners is crucial to end the pediatric AIDS and achieve a HIV-free generation.
  Current HIV research 02/2013;
• Article: Virologic and Host Risk Factors for Mother-to-Child Transmission of HIV.

  Shanmugapriya Selvaraj, Elijah Paintsil
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  ABSTRACT: Mother-to-child transmission (MTCT) of HIV continues to fuel the worldwide pediatric HIV epidemic. Without any intervention to prevent transmission, the rate of MTCT of HIV is estimated at 12-40%. The prevalence of pediatric HIV infection in a given community is the sensor for both the magnitude and the trajectory of the HIV epidemic in that community. A myriad of viral and host risk factors act in tandem to cause MTCT of HIV. In this review, the mechanisms, timing of transmission, and risks factors (i.e., viral and host) associated with MTCT of HIV are discussed. Although significant declines in MTCT have been achieved in both resource-rich and resource-limited countries over time, there are still challenges and threats that have the potential to reverse the gains made so far. Understanding the mechanisms, timing, and viral and host factors associated with MTCT of HIV will help to identify appropriate interventions and suitable antiretroviral chemoprophylaxis regimens to reduce or eliminate MTCT.
  Current HIV research 02/2013;
• Article: Immunotherapies to Prevent Mother to Child Transmission of HIV.

  Mark D Hicar
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  ABSTRACT: Although pharmacological interventions have been successful in reducing prevention of maternal to child transmission (PMTCT) of HIV, there is concern that complete elimination through this mode of transmission will require other measures. Immunotherapies in infants or pregnant mothers may be able to eradicate this form of transmission. A recent vaccine trial in adults shows encouraging results, but as in most HIV safety and efficacy vaccine trials, the question of MTCT was not addressed. Concentrating transmission studies and vaccine studies in the setting of MTCT offers several advantages. MTCT has a generally reproducible known transmission rate and has been successfully used to assess pharmacological interventions on decreasing transmission. Even in resource poor settings, the infrastructure for neonatal vaccination is already in place. Although rare, both passive and active vaccination trials have been successfully completed in pediatric populations. Unfortunately, little success in affecting MTCT has been shown. Largely, a correlate of protection in any type of transmission, including MTCT, is unknown. Data supports a role for antibodies in effecting strain and transmission during MTCT. The role of antibodies in MTCT is reviewed with a focus on recent passive immunization and considerations for future studies.
  Current HIV research 02/2013;
• Article: HIV Drug Resistance in Mothers and Infants Following Use of Antiretrovirals to Prevent Mother-to-Child-Transmission.

  Quy Ton, Lisa Frenkel
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  ABSTRACT: The purpose of this article is to review prominent studies on HIV drug-resistance in mothers and their infants after the use of antiretroviral drugs to prevent mother-to-child-transmission in resource-limited communities. The effects of drug-resistance on subsequent combination antiretroviral therapy are discussed, as are the probable mechanisms of acquisition and decay or persistence of drug-resistant mutants. Differences in the rates of HIV drug-resistance from interventions used to prevent mother-to-child-transmission in North America and Europe are contrasted to the simplified regimens used in resource-limited settings. Unresolved issues related to HIV drug-resistance are reviewed, including: whether maternal zidovudine monotherapy selects significant resistance; the clinical relevance of HIV drug-resistant variants selected by single-dose nevirapine that persist as minority viral variants and can affect the outcome of non-nucleoside reverse transcriptase inhibitor-based therapy; and the use of maternal combination antiretroviral therapy during breastfeeding. Finally, the current and upcoming strategies to reduce HIV drug-resistance related to use of antiretrovirals to prevent mother-to-child-transmission are discussed and contrasted with the challenges of financing and administering antiretrovirals to prevent mother-to-child-transmission in resource-limited communities.
  Current HIV research 02/2013;
• Article: Operational Issues and Barriers to Implementation of Prevention of Mother-to-Child Transmission of HIV (PMTCT) Interventions in Sub-Saharan Africa.

  Jim Aizire, Mary Glenn Fowler, Hoosen M Coovadia
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  ABSTRACT: Over the past 10 years substantial progress has been made in the implementation of prevention of mother-to child transmission of HIV (PMTCT) interventions in Sub-Saharan Africa (SSA). In spite of this, new pediatric infections remain unacceptably high, contributing the majority (>90%) of the estimated 390,000 infections globally in 2010; and yet prolonged breastfeeding remains the norm and crucial to overall infant survival. However, there is reason for optimism given the 2010 World Health Organization PMTCT recommendations: to start HIV infected pregnant women with CD4 cell counts less than 350 cells/mm3 on lifelong antiretroviral therapy (ART); and for mothers not eligible for ART to provide efficacious maternal and/or infant PMTCT antiretroviral (ARV) regimens to be taken during pregnancy, labor/delivery and through breastfeeding. Current attention is on whether to extend maternal ARVs for life once triple ARV PMTCT regimens are started. To dramatically reduce new pediatric infections, individual countries need to politically commit to rapid scale-up of a multi-pronged PMTCT effort: including primary prevention to reduce HIV incidence among women of reproductive age; increased access to family planning services; HIV screening of all pregnant and breastfeeding women followed by ART or ARVs for PMTCT; and comprehensive care for HIV affected families. Efforts to achieve population-level success in SSA need to critically address operational issues and challenges to implementation (health system) and utilization (social, economic and cultural barriers), at the country, health centre and client level that have led to the relatively slow progress in the scale-up of PMTCT strategies.
  Current HIV research 02/2013;
• Article: Barriers to Participation in Actual HIV Vaccine Trials.

  Shayesta Dhalla, Gary Poole
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  ABSTRACT: Cognitive barriers to participation in actual HIV vaccine trials have not been previously comprehensively reviewed. In this review article, barriers in actual early phase, phase 2B, and phase 3 HIV vaccine trials are quantified and categorized, and compared between the Organization for Economic Co-operation and Development (OECD) countries and the non-OECD countries. Participation rates were standardized to allow for comparisons. In both the OECD and the non-OECD countries, barriers included subjective norms and discrimination, vaccine safety concerns, and logistical concerns. More actual HIV vaccine trials can incorporate questions about and quantify barriers to participation, and this may aid future recruitment strategies.
  Current HIV research 02/2013;
• Article: Lactoferrin, a Marker for Periodontal Disease.

  Alan Grupioni Lourenço, Cristiano Nakao, Alcyone Artioli Machado, Ana Carolina Fragoso Motta, Ludmilla Tonani, Regina Célia Candido, Marilena Chinali Komesu
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  ABSTRACT: This study evaluated the salivary concentrations of lactoferrin (Lf) in HIV-seropositive and -seronegative subjects correlating these levels with the incidence of periodontal disease, quantity of Candida spp and systemic condition of the HIV-seropositives (viral load and T lymphocytes CD-4+ count and antiretroviral therapy). Whole saliva samples were obtained from 109 subjects who were divided into four groups according to the extent of their HIV infection and their periodontal condition. The salivary Lf concentrations were determined by a standard enzyme-linked immunosorbent assay and the quantification of Candida spp. was obtained from all subjects. Among the HIV- participants, higher concentrations of Lf were found in individuals with periodontal diseases (p< 0.0001). A similar result was found for HIV+ participants (p< 0.0001). No correlation was found between the concentration of salivary Lf and the quantification of Candida spp or between the Lf concentration and the systemic condition of the HIV+ subjects. The existence of periodontal diseases can modulate an early inflammatory process in the oral mucosa by increasing the expression of Lf, where Lf can act as an antibacterial peptide in HIV- and HIV+ patients. These results suggest that Lf is a possible marker for periodontal diseases in immunocompetent and immunocompromised subjects.
  Current HIV research 02/2013;
• Article: Low-Abundance Resistant Mutations in HIV-1 Subtype C Antiretroviral Therapy-Naïve Individuals as Revealed by Pyrosequencing.

  Sandra Gonzalez, Damien C Tully, Clement Gondwe, Charles Wood
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  ABSTRACT: Given the recent scale-up of antiretroviral therapy (ART) in sub-Saharan Africa, we sought to determine how often and at what levels do drug-resistant mutant variants exist in ART-naïve HIV subtype C infected individuals. Samples from 10 ART-naïve Zambian individuals were subjected to ultra-deep pyrosequencing (UDPS) to characterize the frequency of low-abundance drug resistance mutations in the pol gene. Low-abundance clinically relevant variants were detected for nucleoside reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs) and protease inhibitors (PIs) in eight of the ten subjects. Intermediate to high-level resistance was predicted for the majority of NRTIs. Mutations conferring resistance to most first-line and some second-line therapy drugs were also observed. UDPS detected a number of additional major resistant mutations suggesting that these individuals may have an increased risk of virological failure after initiating ART. Moreover, the effectiveness of first-line and even some second-line ART may be compromised in this setting.
  Current HIV research 01/2013;
• Article: The origin of lentivirus research: maedi-visna virus.

  Halldor Thormar
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  ABSTRACT: Maedi and visna are contagious sheep diseases which were introduced into Iceland in 1933 by imported sheep of Karakul breed. Maedi, a slowly progressing pneumonia, and the central nervous system disease visna were shown to be transmissible in sheep and most likely caused by a virus. In 1957, visna virus was isolated in tissue culture from sheep brain and maedi virus was isolated the following year from sheep lungs. Both viruses showed similar cytopathic effect in tissue culture. Electron microscope studies of ultrathin sections from visna virus infected cells demonstrated spherical particles, 70-100 nm in diameter, which were formed by budding from the cell membrane. Later studies showed identical particles in maedi virus infected cultures. These, and several other comparative studies, strongly indicated that maedi and visna were caused by strains of the same virus, later named maedi-visna virus (MVV). Comparative studies in tissue culture suggested that MVV was related to RNA tumor viruses of animals, the oncornaviruses. This was later supported by the finding that MVV is an RNA virus. A few months after reverse transcriptase was demonstrated in oncornaviruses, the enzyme was also found in MVV virions. Thus, MVV was classified as a retrovirus together with the oncornaviruses. However, MVV is not oncogenic in vivo or in vitro and was in 1975 placed in a subgroup of retroviruses named lentiviruses, which cause cytopathic effect in vitro and slowly progressing inflammatory disease in animals, but are non-oncogenic. In the early 1980s, the causative agent of AIDS was found to be a non-oncogenic retrovirus and was classified as a lentivirus. Thus, HIV became the first human lentivirus.
  Current HIV research 12/2012;
• Article: The Role of Co-Infections in Mother-to-Child Transmission of HIV.

  Caroline C King, Sascha R Ellington, Athena P Kourtis
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  ABSTRACT: In HIV-infected women, co-infections that target the placenta, fetal membranes, genital tract, and breast tissue, as well as systemic maternal and infant infections, have been shown to increase the risk for mother-to-child transmission of HIV (MTCT). Active co-infection stimulates the release of cytokines and inflammatory agents that enhance HIV replication locally or systemically and increase tissue permeability, which weakens natural defenses to MTCT. Many maternal or infant co-infections can affect MTCT of HIV, and particular ones, such as genital tract infection with herpes simplex virus, or systemic infections such as hepatitis B, can have substantial epidemiologic impact on MTCT. Screening and treatment for co-infections that can make infants susceptible to MTCT in utero, peripartum, or postpartum can help reduce the incidence of HIV infection among infants and improve the health of mothers and infants worldwide.
  Current HIV research 12/2012;