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Fact Sheet
Perinatal and Postnatal Transmission* of HIV Infection

February 1999

Contents:


* This fact sheet uses the term "perinatal transmission" to mean vertical transmission of the HIV virus from an infected woman to her infant during pregnancy, at the time of birth, or in the week after birth; and the term "postnatal transmission" to mean vertical HIV transmission within 1 year after childbirth.


Numbers and Proportions


Infants Affected; Populations at Risk


Maternal Exposure Categories


Recent Trends in Treatment and Transmission Rates


Natural History(7, 8)


Treatment and Prevention: Treatment of the Woman During Pregnancy and Other Factors in the Prevention of Mother-to-Child HIV Transmission


Treatment


Treatment Guidelines and Reports


Prevention Issues in Addition to ZDV Treatment


Services


Research and Information Resources


References

  1. Centers for Disease Control and Prevention (CDC). (1998). Status of Perinatal HIV Prevention: U.S. Declines Continue: Hope for Extending Success to Developing World. Centers for Disease Control and Prevention. June, 1998.

  2. Institute of Medicine (IOM), National Academy Press. 1998. Reducing the Odds: Preventing Perinatal Transmission of HIV in the U.S.

  3. Centers for Disease Control and Prevention (CDC), National Center for HIV, STD and TB Prevention. (1998). HIV/AIDS Surveillance Reports, Mid-year 1998 Edition, Vol.10, No.1; Atlanta GA 30333; December 1998.

  4. Centers for Disease Control and Prevention (CDC), National Center for HIV, STD and TB Prevention (1998). HIV/AIDS Surveillance Reports, Year-end 1997 Edition. Vol. 9, No. 2. Atlanta GA 30333. December 1998.

  5. Centers for Disease Control and Prevention (CDC). (1997). Perinatally acquired HIV/AIDS. MMWR, 46:1086-92.

  6. Centers for Disease Control and Prevention (CDC). August 28, 1998. Success in Implementing Public Health Service Guidelines to Reduce Perinatal Transmission of HIV in Louisiana, Michigan, New Jersey, and South Carolina, 1993, 1995, and 1996. MMWR.

  7. "Pregnancy in the Setting of HIV Infection."

  8. "Pediatric HIV Infection." Nielson, Karen.

  9. Trends in the HIV and AIDS Epidemic, 1998 - National Center for HIV, STD, and TB Prevention.

  10. Lack of Long-Term Effects of In Utero Exposure to Zidovudine Among Uninfected Children Born to HIV-Infected Women. Culnane, Mary et al, Journal of the American Medical Association; 281;2,51, January 13 1999.

  11. State of Perinatal HIV Prevention in the United States: CDC Statement following the Institute of Medicine Report. Press Release October 14, 1998.

  12. MMWR, August 28, 1998.

  13. The Mode of Delivery and the Risk of Vertical Transmission of Human Immunodeficiency Virus Type 1 -- A Meta-Analysis of 15 Prospective Cohort Studies. The International Perinatal HIV Group, New England Journal of Medicine, April 1, 1999.

  14. Surveillance of Pediatric HIV Infection, American Academy of Pediatrics, Committee on Pediatric AIDS. Pediatrics. February 1998, 101: 315-319.

  15. "Reporting Requirements of Diseases and Conditions Under National Surveillance" from the Council of State and Territorial Epidemiologists.
* Noted by the CDC in the HIV/AIDS Surveillance Reports: Since HIV infection is not uniformly reported throughout the United States (not all states report HIV infection cases, unlike the reporting of AIDS cases), estimates of HIV infection in the population are currently limited and difficult.


Further Reading


Other Information Resources


Recent Quotes About Perinatal Transmission

"To boost prevention efforts, the federal government should establish a regional system of perinatal HIV prevention and treatment centers. These centers would help assure optimal HIV care for all pregnant women and newborns, and would help develop and implement strategies to improve HIV testing in prenatal care. Federal, state, and local public health agencies also should maintain appropriate surveillance data on HIV-infected women and children"
-- Institute of Medicine Report, 1998.

"By making HIV screening a routine part of prenatal care for all pregnant women, regardless of their risk factors or where they live, we can further lower the number of pediatric AIDS cases and help infected women get high-quality treatment."
-- Dr. Marie McCormick, Professor and Chair, Department of Maternal and Child Health, Harvard School of Public Health, Boston.

"We must recognize that enhanced testing by itself does not assure care for the woman with HIV infection. The prevention of HIV infection in women and children will only occur when there is support for truly inclusive interdisciplinary, culturally sensitive and appropriately supported programs that address all the underlying causes for preventing the spread of HIV infection."
-- From "Reducing the Odds: How to Reach the Unconverted?" by Dr. James Oleske, Francois-Xavier Bagnoud Professor of Pediatrics at New Jersey Medical School and Medical Director of the FXB Center.


Fact sheet compiled by Catherine Briggs, MD MPH

Please feel free to send comments and suggestions about our about "Perinatal and Postnatal Transmission of HIV infection: A Fact Sheet" to ortegaes@umdnj.edu with a subject line "Perinatal and Postnatal Transmission of HIV infection: A Fact Sheet."




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