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Am J Perinatol 2000; 17(8): 429-436
DOI: 10.1055/s-2000-13458
Copyright © 2000 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

MANAGEMENT OF THE INFANT BORN TO A MOTHER INFECTED WITH HUMAN IMMUNODEFICIENCY VIRUS TYPE 1 (HIV-1): CURRENT CONCEPTS

Aracelis D. Fernandez, David F. McNeeley
  • Division of Pediatric Infectious Diseases and Immunology, Weill Medical College of Cornell University, New York, New York
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Publication Date:
31 December 2000 (online)

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ABSTRACT

Despite the use of highly active antiretroviral therapy (HAART) and the success of protocol PACTG-076 in decreasing perinatal transmission of HIV infection in many industrialized countries, a total of 5,600,000 new cases of HIV infection were diagnosed worldwide in 1999. Of those cases, more than 10% are children under 15 years of age. The vast majority of pediatric HIV infection is due to perinatal transmission. More than 95% of HIV-infected people live in the developing world. Different studies are currently being conducted with modifications of the original PACTG-076, especially shorter courses of zidovudine (ZDV), combinations of antiretrovirals (ZDV and 3TC), or comparison of a modified version of the standard ZDV course vs. a single dose of nevirapine for the mother intrapartum and also for the newborn. The results of these studies may provide more affordable, alternative regimens to prevent maternal-to-child HIV-1 transmission for developing countries than the PACTG-076 protocol. It is very important that physicians and physician extenders (nurse practitioners and physician assistants) caring for infants born to HIV-infected mothers have an understanding of the pathophysiology of vertical HIV-1 infection transmission. They should be familiar with the conditions associated with an increased risk of transmission, interventions available to decrease this risk, current medications, and laboratory resources.

KEYWORD

Pediatric HIV infection - pediatric AIDS - perinatal transmission of HIV

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