Global Strategies for the Prevention of Vertical HIV Transmission

Important note: Information in this article was accurate in 1997. The state of the art may have changed since the publication date.

Global Strategies for the Prevention of Vertical HIV Transmission

Journal of the International Association of Physicians in AIDS Care (12/97) Vol. 3, No. 12, P. 19
MacDougall, David S.

Abstract: Although developed nations have enjoyed considerable success in their efforts to reduce the incidence of vertical HIV transmission, developing nations have had relatively little success. In fact, a June 1997 report from UNAIDS reveals that 1,000 children in developing countries become infected with HIV daily, while less than 500 children in the United States are newly infected with the virus each year. In developing nations, prevention efforts are not only hindered by the lack of a fundamental health care system, but also by social problems such as malnutrition, illiteracy, stigmatization, and ignorance. During the September conference Global Strategies for the Prevention of HIV Transmission from Mothers to Infants, sponsored by the American Society for Microbiology, the Office of AIDS Research, National Institutes of Health, and other organizations, strategies to reduce perinatal transmission were discussed. Helene Gayle, director of the Centers for Disease Control and Prevention's National Center for HIV, STD, and TB Prevention, cited a number of reasons for the disparity in the rates of vertical HIV transmission between industrialized and developing countries, particularly the fact that the AZT regimen that demonstrated being effective in the ACTG 076 trial is "simply not feasible for use in most developing countries." Awa Coll-Seck of UNAIDS noted that countries with limited options for the prevention of perinatal transmission may find hope in shorter-course zidovudine regimens--a possibility being examined by studies in Thailand and the Ivory Coast. Still, said Marie-Louise Newell of England's Institute of Child Health, the development of effective methods of preventing vertical HIV transmission depends upon greater understanding of perinatal transmission. While it has been documented that such transmission occurs prenatally and postpartum, most evidence for prenatal HIV infection is largely presumptive and based on the identification of HIV in aborted fetal tissue.

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