Late Postnatal Transmission of HIV‐1 and Associated Factors

Abstract

The risk of LPT beyond 6 months is substantial. Weaning at 6 months could prevent >85% of LPT.

Risk Factors for Late Postnatal Transmission of Human Immunodeficiency Virus Type 1 in Sub-Saharan Africa

“…The HIV-1 RNA concentration in cervicovaginal fluid was not a significant risk factor for transmission in this analysis. However, our results confirm that a higher maternal plasma viral load, previously associated with in utero or intrapartum transmission of HIV-1 (10,13-15) as well as breastfeeding transmission of HIV-1 (11,(15)(16), is an independent risk factor for postnatal transmission of HIV-1 through breastfeeding.…”

Mother-to-child transmission of HIV-1 in sub-Saharan Africa: Past, present and future challenges

“…This difference reflected the variability in the distribution of underlying risk factors, especially the contribution of breastfeeding. Among the major risk factors reported to influence the overall MTCT of HIV were maternal viral load, advanced HIV disease, immunological status, duration of pregnancy, prolonged rupture of membranes, chorioamnionitis, mode of delivery, vitamin A deficiency and breastfeeding (Mmiro et al, 2009;Coovadia, 2009;Semba et al, 1994;van de Perre, 2000;Taha et al, 2007;John-Stewart et al, 2004). However, large non-antiretroviral clinical trials that targeted specific risk factors such as washing the birth canal (Biggar et al, 1996), antenatal supplementation with vitamin A (Semba et al, 1999) and treatment of chorioamnionitis (Taha et al, 2006a) did not reduce the MTCT of HIV in sub-Saharan Africa.…”

HIV Diagnostics: Challenges and Opportunities

“…The current standard of care is to start the newborn on ART while performing DNA NAT at 2 and 4 weeks of age, with two negative test results being a confirmation of no transmission [44]. Frequent monitoring would be needed for breastfeeding infants since transmission can occur through breast milk [45]. Standard practices in RLS include observing the onset of clinical symptoms as indicators of HIV status and preparing DBS to be transported to a laboratory for NAT or an ELISA [28].…”