HIV in pregnancy: strategies for management

Abstract

HIV/AIDS is now the leading cause of mortality in Africa. Measures for preventing HIV infection in women are central to any strategy to manage this disease in pregnancy. The use of anti-retrovirals (ARVs) has reduced vertical transmission in industrialized countries by about two-thirds. Recent ARV trials in developing countries reveal relative efficacies at 6 months of about 40% in breast feeding and 50% in non-breast feeding populations. New data on breast feeding adds to the information on the pathogenesis of postnatal transmission and can influence feeding recommendations. Strategies suitable and inappropriate for developing countries, and operational difficulties, are discussed.