Transmission of HIV to infants whose mothers seroconvert postnatally

BMJ 2010; 341 doi: https://doi.org/10.1136/bmj.c6269 (Published 22 December 2010) Cite this as: BMJ 2010;341:c6269
  1. Jeffrey S A Stringer, professor of obstetrics and gynaecology1,
  2. M Bradford Guffey, instructor of medicine and paediatrics1
  1. 1Centre for Infectious Disease Research in Zambia, Northmead, Lusaka, Zambia, 10101
  1. stringer{at}uab.edu

Primary prevention is the key

In November 2009, the World Health Organization published revised guidelines for the prevention of mother to child transmission of HIV in developing countries that will extend antiretroviral prophylaxis throughout the breastfeeding period.1 If implemented fully, the recommendations promise to reduce vertical transmission rates from 25-48% to 5% or lower.2 3 This has prompted several prominent international organisations to call for the worldwide eradication of AIDS in children.4

Jenny Matthews/Panos

In most of the resource poor world, women and children bear a disproportionate share of the AIDS burden. In sub-Saharan Africa, women account for more than 60% of infections, and in the nine countries in southern Africa most affected by HIV, prevalence among women aged 15–24 years is three times higher than that among men of the same age.5 Pregnant and lactating women are particularly vulnerable to the acquisition of HIV,6 probably because of immunological and hormonal changes that affect the genital tract, and when they seroconvert, their infants are also at high risk of infection.7 More than 20% of new HIV …

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