Prevention of Mother-to-Child HIV Transmission in Resource-Poor Countries

TLDR

Each year, about 590,000 infants acquire HIV from their mothers, mainly in developing countries that cannot implement standard interventions, eroding gains in infant and child survival and underscoring the need for primary prevention among adolescents and women of childbearing age. The article reviews current knowledge of mother‑to‑child HIV transmission in developing countries, summarizes key trial findings, outlines future research needs, and describes public health challenges of implementing perinatal HIV prevention interventions in resource‑poor settings. The authors conduct a review of existing literature and clinical trials on mother‑to‑child HIV transmission, synthesizing evidence and identifying gaps for future research. Recent clinical trials indicate that short‑course antiretroviral regimens could markedly reduce perinatal HIV transmission worldwide, and successful implementation of these interventions could substantially improve global child survival.

Abstract

Each year, an estimated 590,000 infants acquire human immunodeficiency virus type 1 (HIV) infection from their mothers, mostly in developing countries that are unable to implement interventions now standard in the industrialized world. In resource-poor settings, the HIV pandemic has eroded hard-won gains in infant and child survival. Recent clinical trial results from international settings suggest that short-course antiretroviral regimens could significantly reduce perinatal HIV transmission worldwide if research findings could be translated into practice. This article reviews current knowledge of mother-to-child HIV transmission in developing countries, summarizes key findings from the trials, outlines future research requirements, and describes public health challenges of implementing perinatal HIV prevention interventions in resource-poor settings. Public health efforts must also emphasize primary prevention strategies to reduce incident HIV infections among adolescents and women of childbearing age. Successful implementation of available perinatal HIV interventions could substantially improve global child survival.