Preventing Mother-to-Infant HIV Transmission

Treating HIV-infected pregnant women with combination antiretroviral therapy (ART) has nearly eliminated perinatal HIV transmission in the developed world. However, in poor countries, many infected women do not receive ART during pregnancy or lactation. As a result, 430,000 infants acquire HIV each year; of these, approximately 200,000 are infected through breast-feeding. Now, two large trials — one in Botswana and one in Malawi — show that most such postnatal infections can be prevented.

In Botswana, 560 HIV-infected pregnant women with CD4 counts ≥200 cells/mm³ were randomized to receive coformulated abacavir/zidovudine/lamivudine (the nucleoside reverse transcriptase inhibitor [NRTI] group) or lopinavir/ritonavir plus zidovudine/lamivudin…