How is the risk of vertical transmission reduced in pediatric HIV infection?

Updated: Mar 05, 2020
  • Author: Delia M Rivera, MD; Chief Editor: Russell W Steele, MD  more...
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Answer

The risk of vertical transmission may be reduced. Most children are infected by means of vertical transmission. Proper treatment of the mother during pregnancy and delivery and proper treatment of the neonate can reduce the risk of vertical transmission. Prenatal, perinatal, and postnatal treatment along with elective cesarean delivery lower the transmission rate to as low as 2%.

Risk factors for vertical transmission are divided into the 4 categories, as shown in Table 6.

Table 6. Risk Factors for Vertical Transmission (Open Table in a new window)

Period

Factors That Increase Risk

Factors That Decrease Risk

Prenatal

Acute HIV infection

Viral load >10,000

Cigarette smoking

Illicit IV drug use

Viral load < 1000

Zidovudine treatment

Neutralizing antibodies

Perinatal

Rupture of membranes for >4 h

Chorioamnionitis

Emergency cesarean delivery

Surgical delivery

Episiotomy

Use of scalp electrodes

Elective cesarean delivery with zidovudine treatment

Neonatal

Prematurity

Low birth weight

First-born twin

Full-term

Second-born twin

Postdelivery

Breastfeeding

ART


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