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
