Article

Current issues in prevention of mother-to-child transmission of HIV-1

Doris Duke Medical Research Institute, Nelson Mandela School of Medicine, University of Kwazulu-Natal, 719 Umbilo Road, Congella, South Africa 4013, South Africa.
Current opinion in HIV and AIDS (Impact Factor: 4.39). 08/2009; 4(4):319-24. DOI: 10.1097/COH.0b013e32832a9a17
Source: PubMed

ABSTRACT To review new evidence in prevention of mother-to-child-transmission of HIV-1, which establishes, in principle, the feasibility of greatly improved effectiveness in developing countries.
This review presents evidence that demonstrates that a large gap in prevention of mother-to-child-transmission [MTCT] is being increasingly bridged. Recent studies have addressed issues on postnatal transmission of HIV-1 through breastfeeding. Breastfeeding transmission affects the majority of HIV-infected pregnant women and children in the world and who live in Africa and are often poor. Prevention of unwanted pregnancies in all women living in high HIV prevalence regions will probably reduce the risk of HIV-positive pregnancies. These studies demonstrate the success of the following three types of interventions:primary prevention of HIV-1 in women;prophylaxis with antiretroviral drugs in breastfeeding infants;prophylaxis with antiretroviral drugs for lactating mothers.It is also clear that key barriers to implementing these findings in developing countries are weak and ineffectual health systems. Therefore, identifying needs for improving health service delivery are critical; an example of the synergy between prevention and treatment through integrated services is given.
Recent data on primary prevention of HIV-1 in women of child-bearing age, and use of antiretrovirals in breastfeeding infants and lactating mothers, report successful interventions for the prevention of breastfeeding transmission of HIV-1. Health infrastructure improvement in developing countries is central to the application of research findings to implementation of MTCT programmes.

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    • "However, most of the evidence for recommending breastfeeding in developing countries comes from clinical trials performed in Sub-Saharan Africa. Data of formula feeding on child growth and mortality from PMTCT programmes in other continents are scarce, and some developing countries are supporting the use of formula feeding in their national PMTCT programmes [7] [8] [9] [10] [11]. India is the third country in the world in terms of HIV infected people, and it is estimated that 43,000 pregnant women were living with HIV in India in 2009 [12]. "
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