Korean J Pediatr Infect Dis.  2011 Jun;18(1):85-90.

Three Cases of Prevention Therapy to Reduce Perinatal HIV Transmission

• Lee JY
• Park HM
• Hwang SH
• Kim KE
• Shin HJ
• Kim JY

Abstract

In 2008, the Joint United Nations Programme on HIV/AIDS (UNAIDS) estimated that about 430,000 children worldwide became infected with HIV, mostly through mother-to-child transmission (MTCT) during pregnancy, labor, delivery, or breast-feeding. The MTCT prevention program proved to be feasible and effective in reduction of perinatal HIV transmission. Three babies born from HIV-infected mothers were admitted to the National Medical Center in 2009. Only two women received antiretroviral (ARV) therapy during pregnancy, labor, and after delivery, and their infants received zidovudine (AZT) for 6 weeks. The outcome, after a follow-up period of 4 months to 16 months, was favorable in all patients. Thus, we emphasize the need for expansion of antenatal HIV screening of pregnant women, implemented for early HIV diagnosis and effective ARV therapy for reduction of perinatal HIV transmission.

Keyword

HIV; Antiretroviral therapy

MeSH Terms

Child
Female
Follow-Up Studies
HIV
Humans
Infant
Joints
Mass Screening
Mothers
Pregnancy
Pregnant Women
United Nations
Zidovudine
Zidovudine

Reference

1. Adeleke SI, Mukhtar-Yola M, Gwarzo GD. Awareness and knowledge of mother-to-child transmission of HIV among mothers attending the pediatric HIV clinic, Kano, Nigeria. Ann Afr Med. 2009. 8:210–214.

2. Kourtis AP, Bulterys M, Nesheim SR, Lee FK. Understanding the timing of HIV transmission from mother to infant. JAMA. 2001. 285:709–712.

3. Dao H, Mofenson LM, Ekpini R, Gilks CF, Barnhart M, Bolu O, et al. International recommendations on antiretroviral drugs for treatment of HIV-infected women and prevention of mother-to-child HIV transmission in resource-limited settings: 2006 update. Am J Obstet Gynecol. 2007. 197:S42–S55.

4. Jamieson DJ, Clark J, Kourtis AP, Taylor AW, Lampe MA, Fowler MG, et al. Recommendations for human immunodeficiency virus screening, prophylaxis, and treatment for pregnant women in the United States. Am J Obstet Gynecol. 2007. 197:S26–S32.

5. Paintsil E, Andiman WA. Update on successes and challenges regarding mother-to-child transmission of HIV. Curr Opin Pediatr. 2009. 21:94–101.

6. Panel on Treatment of HIV-Infected Pregnant Women and Prevention of Perinatal Transmission. Recommendations for Use of Antiretroviral Drugs in Pregnant HIV-1- Infected Women for Maternal Health and Interventions to Reduce Perinatal HIV Transmission in the United States. 2010. 1–20. Available from: http://aidsinfo.nih.gov/ContentFiles/PerinatalGL.pdf.

7. Connor EM, Sperling RS, Gelber R, Kiselev P, Scott G, O'Sullivan MJ, et al. Pediatric AIDS Clinical Trials Group Protocol 076 Study Group. Reduction of maternal-infant transmission of human immunodeficiency virus type 1 with zidovudine treatment. N Engl J Med. 1994. 331:1173–1180.

8. Zhou Z, Meyers K, Li X, Chen Q, Qian H, Lao Y, et al. Prevention of mother-to-child transmission of HIV-1 using highly active antiretroviral therapy in rural Yunnan, China. J Acquir Immune Defic Syndr. 2010. 53:S15–S22.

9. Newell ML. Antenatal and perinatal strategies to prevent mother-to-child transmission of HIV infection. Trans R Soc Trop Med Hyg. 2003. 97:22–24.

10. Coovadia H. Current issues in prevention of mother-to-child transmission of HIV-1. Curr Opin HIV AIDS. 2009. 4:319–324.

11. Mofenson LM, Lambert JS, Stiehm ER, Bethel J, Meyer WA 3rd, Whitehouse J, et al. Risk factors for perinatal transmission of human immunodeficiency virus type 1 in women treated with zidovudine. N Engl J Med. 1999. 341:385–393.

12. John GC, Nduati RW, Mbori-Ngacha DA, Richardson BA, Panteleeff D, Mwatha A, et al. Correlates of mother-to-child human immunodeficiency virus type 1 (HIV-1) transmission: association with maternal plasma HIV-1 RNA load, genital HIV-1 DNA shedding, and breast infections. J Infect Dis. 2001. 183:206–212.

13. O'Gorman MR, Zijenah LS. CD4 T cell measurements in the management of antiretroviral therapy--A review with an emphasis on pediatric HIV-infected patients. Cytometry B Clin Cytom. 2008. 74:S19–S26.

14. Giaquinto C, Ruga E, Giacomet V, Rampon O, D'Elia R. HIV: mother to child transmission, current knowledge and on-going studies. Int J Gynaecol Obstet. 1998. 63:S161–S165.

15. Shaffer N, Chuachoowong R, Mock PA, Bhadrakom C, Siriwasin W, Young NL, et al. Bangkok Collaborative Perinatal HIV Transmission Study Group. Short-course zidovudine for perinatal HIV-1 transmission in Bangkok, Thailand: a randomised controlled trial. Lancet. 1999. 353:773–780.

16. Dunn DT, Simonds RJ, Bulterys M, Kalish LA, Moye J Jr, de Maria A, et al. Interventions to prevent vertical transmission of HIV-1: effect on viral detection rate in early infant samples. AIDS. 2000. 14:1421–1428.

17. Pinkerton SD, Holtgrave DR, Layde PM. Incremental cost-effectiveness of two zidovudine regimens to prevent perinatal HIV transmission in the United States. Prev Med. 2000. 30:64–69.

18. Pyrgos V, Shoham S, Roilides E, Walsh TJ. Pneumocystis pneumonia in children. Paediatr Respir Rev. 2009. 10:192–198.

19. King SM. American Academy of Pediatrics Committee on Pediatric AIDS. American Academy of Pediatrics Infectious Diseases and Immunization Committee. Evaluation and treatment of the human immunodeficiency virus-1--exposed infant. Pediatrics. 2004. 114:497–505.