Perinatal HIV transmission and prevention

  • Dr.Rabindran Chandran Consultant Neonatologist, Billroth Hospital, Chennai, India
Keywords: Perinatal HIV, Anti-retroviral therapy, Zidovudine


Perinatal HIV transmission occurs during pregnancy, labor, delivery or breastfeeding. Maternal factors associated with increased perinatal transmission include timing of infection, immune status, mode of delivery, co-existing sexually transmitted diseases, illicit drug use, increased duration of ruptured membranes, chorioamnionitis, viral load & invasive procedures. Infant risk factors include premature birth, low birth weight, skin & mucous membrane lesions. Preventive measures include anti retroviral therapy, treatment of chorioamnionitis with antibiotics, opting for caesarean section & avoiding breastfeeding. Early appropriate treatment of subclinical chorioamnionitis & virocidal cleaning of birth canal reduces perinatal HIV transmission. Caesarean section before onset of labour & membrane rupture reduces risk of mother–infant transmission by almost 50%. Vertical HIV transmission can occur through breast-feeding mostly during first 6 weeks of life & hence avoiding breastfeeding reduces transmission. Interrupting intrapartum transmission like giving ART in late gestation/ peri-partum & elective caesarean section reduce vertical HIV acquisition. As monotherapy & dual therapy are less effective, current guidelines recommend 2 nucleoside reverse transcriptase inhibitors & either a nonnucleoside reverse transcriptase inhibitor or a protease inhibitor. Perinatal HIV transmission can be reduced through a comprehensive approach including Universal access to prenatal care & routine HIV counselling & testing, access to antiretroviral therapy during pregnancy, at delivery & postpartum, education about treatment options & regimen adherence.


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Perinatal HIV transmission and prevention
DOI: 10.17511/joog.2016.i02.04
Published: 2016-06-30
How to Cite
Chandran, R. (2016). Perinatal HIV transmission and prevention. Obs Gyne Review: Journal of Obstetric and Gynecology, 2(2), 12-16.
Review Article