Antiretrovirals for reducing the risk of mother-to-child transmission of HIV infection

Progress in HIV vaccine development

“…6,7 Thus, the need for ART is lifelong and the cost is substantial 8,9 and may be difficult to sustain economically. 10 Although ART is highly efficacious in preventing transmission in the setting of mother to child transmission, 11 in sexual transmission through the treatment of infected partners in serodiscordant relationships, 12 through pre-exposure, 4,13,14 or post-exposure prophylaxis 15 scale-up difficulties and costs may make widespread implementation challenging. Furthermore, adherence is critical to the efficacy of biomedical preventive interventions but has been varied across study populations.…”

Progress of preventing mother-to-child transmission of HIV at primary healthcare facilities and district hospitals in three South African provinces

“…1 In wealthy countries, transmission rates are below 2%. 2,3 In South Africa, the revised clinical guidelines introduced in 2010 included starting dual zidovudine/nevirapine prophylaxis commencing from 14 weeks' gestation or lifelong antiretroviral treatment (ART) for pregnant women with World Health Organization stage III or IV HIV disease and/or CD4 cell counts below 350 cells/µl. 4 However, improving South African PMTCT outcomes has been challenging owing to inadequate coverage and sub-optimal implementation of PMTCT programmes.…”

HIV in pregnant women and prevention of perinatal transmission

“…Vertical transmission is highest in primary and secondary syphilis, continuing throughout pregnancy while the severity of outcomes decreases 7 . Adverse outcomes can include stillbirth or miscarriage, perinatal death, prematurity, low birthweight, and a series of early congenital manifestations (e.g.…”

“…The most important intervention to reduce perinatal HIV transmission is antiretroviral therapy for the mother 7 . It has been well established that combination therapy (rather than monotherapy) is the most effective method for reducing maternal viral load, the most important predictor of perinatal transmission 8 .…”