Short-course oral zidovudine for prevention of mother-to-child transmission of HIV-1 in Abidjan, Côte d'Ivoire: a randomised trial

Wiktor, Stefan Z.; Ekpini, Ehounou R.; Karon, John M.; Nkengasong, John N.; Maurice, Chantal; Severin, Sibailly T; Roels, Thierry H.; Kouassi, Moïse K; Lackritz, Eve; Coulibaly, Issa-Malick; Greenberg, Alan E.

doi:10.1016/s0140-6736(98)10412-9

Cited by 490 publications

(198 citation statements)

References 16 publications

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“…2 Before treatment or interventions to prevent transmission were available, the rate of MTCT of HIV-1 in the United States was approximately 25%. 3 Major successes have been achieved in prevention of MTCT of HIV-1 in the United States; the MTCT rate has decreased to less than 2% 4 with antiretroviral treatment of HIV-1-infected pregnant women and, for women who do not yet require treatment of their HIV-1 infection, with the use of the following efficacious interventions to prevent transmission: antiretroviral prophylaxis, 3,[5][6][7][8][9][10][11] cesarean section before labor and before rupture of membranes, 12 and complete avoidance of breastfeeding. 13 The estimated annual number of perinatal HIV-1 infections in the United States has decreased from a peak of 1650 infections in 1991 14 to an estimated 111 infections in 2005.…”

Section: Introductionmentioning

confidence: 99%

Diagnosis of HIV-1 Infection in Children Younger Than 18 Months in the United States

Read¹

2007

Pediatrics

115

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The objectives of this technical report are to describe methods of diagnosis of HIV-1 infection in children younger than 18 months in the United States and to review important issues that must be considered by clinicians who care for infants and young children born to HIV-1–infected women. Appropriate HIV-1 diagnostic testing for infants and children younger than 18 months differs from that for older children, adolescents, and adults because of passively transferred maternal HIV-1 antibodies, which may be detectable in the child's bloodstream until 18 months of age. Therefore, routine serologic testing of these infants and young children is generally only informative before the age of 18 months if the test result is negative. Virologic assays, including HIV-1 DNA or RNA assays, represent the gold standard for diagnostic testing of infants and children younger than 18 months. With such testing, the diagnosis of HIV-1 infection (as well as the presumptive exclusion of HIV-1 infection) can be established within the first several weeks of life among nonbreastfed infants. Important factors that must be considered when selecting HIV-1 diagnostic assays for pediatric patients and when choosing the timing of such assays include the age of the child, potential timing of infection of the child, whether the infection status of the child's mother is known or unknown, the antiretroviral exposure history of the mother and of the child, and characteristics of the virus. If the mother's HIV-1 serostatus is unknown, rapid HIV-1 antibody testing of the newborn infant to identify HIV-1 exposure is essential so that antiretroviral prophylaxis can be initiated within the first 12 hours of life if test results are positive. For HIV-1–exposed infants (identified by positive maternal test results or positive antibody results for the infant shortly after birth), it has been recommended that diagnostic testing with HIV-1 DNA or RNA assays be performed within the first 14 days of life, at 1 to 2 months of age, and at 3 to 6 months of age. If any of these test results are positive, repeat testing is recommended to confirm the diagnosis of HIV-1 infection. A diagnosis of HIV-1 infection can be made on the basis of 2 positive HIV-1 DNA or RNA assay results. In nonbreastfeeding children younger than 18 months with no positive HIV-1 virologic test results, presumptive exclusion of HIV-1 infection can be based on 2 negative virologic test results (1 obtained at ≥2 weeks and 1 obtained at ≥4 weeks of age); 1 negative virologic test result obtained at ≥8 weeks of age; or 1 negative HIV-1 antibody test result obtained at ≥6 months of age. Alternatively, presumptive exclusion of HIV-1 infection can be based on 1 positive HIV-1 virologic test with at least 2 subsequent negative virologic test results (at least 1 of which is performed at ≥8 weeks of age) or negative HIV-1 antibody test results (at least 1 of which is performed at ≥6 months of age). Definitive exclusion of HIV-1 infection is based on 2 negative virologic test results, 1 obtained at ≥1 month of age and 1 obtained at ≥4 months of age, or 2 negative HIV-1 antibody test results from separate specimens obtained at ≥6 months of age. For both presumptive and definitive exclusion of infection, the child should have no other laboratory (eg, no positive virologic test results) or clinical (eg, no AIDS-defining conditions) evidence of HIV-1 infection. Many clinicians confirm the absence of HIV-1 infection with a negative HIV-1 antibody assay result at 12 to 18 months of age. For breastfeeding infants, a similar testing algorithm can be followed, with timing of testing starting from the date of complete cessation of breastfeeding instead of the date of birth.

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Section: Introductionmentioning

confidence: 99%

Diagnosis of HIV-1 Infection in Children Younger Than 18 Months in the United States

Read¹

2007

Pediatrics

115

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“…Following this landmark study, different ART regimens have demonstrated variable impact in the reduction of HIV-1 vertical transmission rates (Dabis et al 1999, Guay et al 1999, Shaffer et al 1999, Wiktor et al 1999, PST 2002, Lallemant et al 2004, Read et al 2007). In addition to ART, other interventions have contributed to the reduction of HIV-1 vertical transmission, such as elective cesarean section (C-section) (IPHIVG 1999, EMDC 1999, vaginal cleaning during the intrapartum period (Taha et al 1997), vitamin A supplementation (Semba 1997), and avoidance of breastfeeding (Nduati et al 2001, RoUsseau et al 2004.…”

mentioning

confidence: 99%

Determinants and trends in perinatal human immunodeficiency virus type 1 (HIV-1) transmission in the metropolitan area of Belo Horizonte, Brazil: 1998 - 2005

Kakehasi

Pinto

Romanelli

et al. 2008

Mem. Inst. Oswaldo Cruz

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“…Many kinds of therapies have now been tested, such as a short-course zidovudine trial, which, although less efficient than the long-term ATCG 076 treatment, still protects approximately 50% of the children of HIV-1 infected mothers (Thaineua et al 1998, Wiktor et al 1999. Protease inhibitors such as a single-dose nevirapine treatment or nelfinavir mesylate (Krogstad et al 1999b) and several combination therapies (Purswani et al 1999, Kline et al 1999) have been tested in pregnant women and children, with acceptable toxicity and high effectiveness.…”

Section: Antiretroviral Drugsmentioning

confidence: 99%

Vertical human immunodeficiency virus type 1 - HIV-1 -transmission - a review

Bongertz¹

2001

Mem. Inst. Oswaldo Cruz

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Short-course oral zidovudine for prevention of mother-to-child transmission of HIV-1 in Abidjan, Côte d'Ivoire: a randomised trial

Cited by 490 publications

References 16 publications

Diagnosis of HIV-1 Infection in Children Younger Than 18 Months in the United States

Diagnosis of HIV-1 Infection in Children Younger Than 18 Months in the United States

Determinants and trends in perinatal human immunodeficiency virus type 1 (HIV-1) transmission in the metropolitan area of Belo Horizonte, Brazil: 1998 - 2005

Vertical human immunodeficiency virus type 1 - HIV-1 -transmission - a review

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