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.
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