Preventing Mother-to-Child Transmission of HIV — Protecting This Generation and the Next

HIV Drug Resistance in Mothers and Infants Following Use of Antiretrovirals to Prevent Mother-to-Child Transmission

“…One study detected no NVP resistance among women receiving a 1-month tail of ddI/ZDV, which was significantly less compared to historical controls (0 % vs. 10.4 %, respectively, by consensus sequencing and 1.8 % vs. 18.9 % by OLA, p = <0.001 for both analyses) (Lallemant and Jourdain 2010). A second study of tails comprised of 1 week of ddI/ZDV/LPV/rt, 1 month of ddI/ZDV, and 1 month of ddI/ZDV/LPV/rt similarly detected no NVP resistance in any group by consensus sequencing and 1.8 %, 7.1 %, and 5.3 % by OLA, respectively, which compared favorably to untreated historical controls with 13.4 % by sequencing and 29.4 % by OLA (p < 0.001 for each study arm vs. comparison group) (Van Dyke et al 2012).…”

Promoting Drug Development and Access: The Role of International Networks and Organizations

“…Many deaths in children with HIV/AIDS were not accounted for and many children were orphaned as a result of losing their parents to the same disease. Today, thanks to the effective implementation of the use of ARV during pregnancy for prevention of mother to child transmission of HIV, perinatal transmission in the developed countries including some emerging countries such as Thailand and Brazil, has been eliminated [ 11 ]. However, despite a decrease in the number of new cases, the number of children living with HIV/AIDS continue to be highest in sub-Saharan Africa and treatment coverage remains low, at 25 %, half that of adults [ 7 ].…”

24-Month adherence, tolerance and efficacy of once-a-day antiretroviral therapy with didanosine, lamivudine, and efavirenz in African HIV-1 infected children: ANRS 12103/12167

“…Study population and eligibility criteria Eligibility criteria were: i) Children infected with HIV-1 between the ages of 30 months and 15 years, and weighting more than 10 kilograms, ii) naive to any antiretroviral treatment except for the prevention of mother-to-child transmission, iii) children <5 years: clinical stage C of the CDC Atlanta classification and / or CD4 in percentage (CD4%) < 15% or stage A, B or N and 15% < CD4 < 20%, iv) children >5 years CD4/mm3 < 200/mm3 regardless of viral plasma RNA or < 200/mm 3 < CD4 <500/mm 3 and viral plasma RNA> 100,000 copies per milliliter (copies / ml), v) the allowed values of other laboratory parameters were: hemoglobin > 7 g/dl, platelets > 50,000/mm 3 , amylase <2.5 times the upper limit of normal, aspartate aminotransferase and alanine aminotransferase <5 times the upper limit of normal. Clinical, immunological and viral criteria were adapted to Penta guidelines 10 Parents or guardians signed an informed consent to allow their children to participate in the trial.…”

“…With more than 95% of worldwide infections affecting children, pediatric HIV-1 infection constitutes a public health challenge in developing countries [1][2][3] . In 2008, it was recommended that early antiretroviral therapy started with children born to HIV positive mothers reduce mortality and morbidity related to HIV 4 .…”