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Preventing mother-to-child transmission of acquired immunodeficiency syndrome (AIDS) is crucial in Europe. Strategies focus on preventing HIV transmission during pregnancy, birth, and breastfeeding, as effective treatments are limited.
Area of Science:
- Infectious Diseases
- Public Health
- Pediatrics
Context:
- Acquired immunodeficiency syndrome (AIDS) presents a significant challenge for women and children in Europe.
- Intravenous drug abuse is a primary transmission route, with heterosexual transmission increasingly prevalent.
- Human immunodeficiency virus (HIV) seropositive mothers pose a substantial risk of perinatal transmission to their infants.
Purpose:
- To review current understanding and management of acquired immunodeficiency syndrome (AIDS) in European women and children.
- To highlight transmission routes, including intravenous drug abuse, heterosexual contact, and perinatal transmission.
- To discuss obstetric practices and preventive measures for human immunodeficiency virus (HIV) in pregnancy.
Summary:
- Perinatal human immunodeficiency virus (HIV) transmission rates from seropositive mothers range from 30% to 40%, with significant morbidity and mortality in affected infants.
- Evidence supports transplacental transmission, with intrapartum transmission also a possibility.
- Recommended preventive strategies include avoiding breastfeeding and considering pregnancy termination, alongside ongoing research into prenatal diagnosis and antiviral therapies.
Impact:
- Highlights the critical need for preventive measures against acquired immunodeficiency syndrome (AIDS) in vulnerable populations.
- Underscores the importance of further research into perinatal human immunodeficiency virus (HIV) transmission routes and interventions.
- Informs obstetric and public health strategies to mitigate the impact of HIV on women and children in Europe.
Abstract:
Acquired immunodeficiency syndrome has become a major problem in women and children in European countries. The most frequent cause of contamination is intravenous drug abuse but heterosexual transmission appears to be more and more frequent. If the mother is seropositive, the proportion of contaminated infants is about 30% to 40%. Half of them develop AIDS within three years and nearly all of them have some clinical manifestations within five years. Numerous data provide clear evidence of transplacental transmission but the possibility of intrapartum transmission cannot be excluded. The procedures adopted by most obstetricians is discussed: abortion during first trimester and sometimes second trimester of pregnancy, spontaneous delivery or cesarean section. Breast milk has been implicated as a transmission mode for HIV so in Europe it is recommended that seropositive mothers not breast-feed. In the absence of a vaccine or effective therapy, the author insists on preventive measures. Further research is needed to delineate the route of perinatal transmission, the part of prenatal diagnosis and the effect of treatment with antiviral agents.