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BMJ No 7108 Volume 315 Letters Saturday 6 September 1997 Screening for HIV infection should be part of routine antenatal screeningEditor,In pregnant women with HIV infection, zidovudine (taken by mouth antenatally, given intravenously during delivery, and then given by mouth to the baby for six weeks) reduces the risk of perinatal transmission of the infection from about 26% to 8%.(1) This treatment is effective regardless of the mother's viral load(2) and is now advised for all pregnant women with HIV infection.(3) If evidence based treatments are to be adopted in antenatal management then antenatal screening policies need to be reassessed. There should be guidelines from the Department of Health and a national education programme offering routine HIV testing and explaining the importance of treatment for those whose result is positive.(4) This ought to be part of routine screening for all pregnant women unless they refuse such testing. How many antenatal clinics already offer routine testing? We should not withhold tests and treatments known to make a difference to the transmission of such a serious infection, and there ought to be a renewed debate about this issue. Ben Essex
Sydenham Green Health Centre, References 1 Connor E M, Sperling R S, Gelber R, Kiselev P, Scott G, O'Sullivan M J, et al for the 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;331:1173-80.
2 Sperling R S, Shapiro D E, Coombs R W, Todd J A, Herman S A, McSherry
G D, et al for the Pediatric AIDS Clinical T
3 Major advances in the treatment of HIV-1 infection. Drug
Ther Bull 1997;35(4):28.
4 Noone A, Goldberg D. Antenatal HIV testing: what now?
BMJ 1997;314:1429-30. (14 May.)
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