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Human Immunodeficiency Virus Type 1 

Human Immunodeficiency Virus Type 1
Chapter:
Human Immunodeficiency Virus Type 1
Author(s):

Amy S. Sturt

and Jennifer S. Read

DOI:
10.1093/med/9780190604813.003.0008
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date: 23 September 2019

Mother-to-child transmission (MTCT) represents the most common means of acquisition of human immunodeficiency virus type 1 (HIV) infection in children, and it can occur in utero, intrapartum, and postnatally through breastfeeding. Interventions during each of these time periods can reduce the risk of MTCT. MTCT prevention involves a cascade of services, including contraception to avoid unintended pregnancies, prenatal care (including universal HIV screening and antiretrovirals), cesarean section before labor and before ruptured membranes when indicated, and complete avoidance of breastfeeding when possible. After delivery, infant HIV acquisition can be mitigated through the provision of antiretroviral prophylaxis. More data are needed regarding the mode of delivery and whether cesarean section is beneficial in women with a delivery viral load of less than 1,000 copies/mL who are using effective antiretroviral therapy (ART) regimens. There is also a need for better understanding of the optimal duration of infant post exposure prophylaxis both after birth and during breastfeeding.

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