[Mother-to-child HIV transmission]

Vertical HIV transmission is the main route of infection in children. The vast majority of infected children are born in the developing world. In the developed countries, including the Czech Republic, the situation is relatively favourable thanks to preventive activities and effective prophylactic measures in HIV-positive pregnant women. The risk of vertical transmission depends on a number of maternal (including immunological), virological, obstetric, feto-placental and neonatal factors. The basic prophylactic steps are: administration of antiretroviral agents, delivery by Caesarean section and avoidance of breast-feeding. Diagnosis of HIV infection in children relies on direct virological diagnosis -- the demonstration of the absence of viral genome in blood samples taken at the age of 2-3 and 4-6 months is crucial for excluding vertical infection. In the first 6 weeks of life, children receive the zidovudine prophylaxis. From the age of 6-8 weeks until approx. 6 months, children in whom HIV infection has not been excluded are on the primary co-trimoxazole prophylaxis of Pneumocystis infection.