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The End Is in Sight: Current Strategies for the Elimination of HIV Vertical Transmission
Lanbo Yang1, Mary Catherine Cambou2, Karin Nielsen-Saines3
1Warren Alpert Medical School, Brown University, 222 Richmond Street, Providence, RI, 02903, USA. lanbo_yang@brown.edu.
Purpose Of Review:
The goal of this review is to highlight and interpret recent trends and developments in the diagnosis, treatment, and prevention of HIV vertical transmission from a clinical perspective.
Recent Findings:
Universal third-trimester retesting and partner testing may better identify incident HIV among pregnant patients and result in early initiation of antiretroviral therapy to prevent vertical transmission. The proven safety and efficacy of integrase inhibitors such as dolutegravir may be particularly useful in suppressing viremia in pregnant persons who present late for ART treatment. Pre-exposure prophylaxis (PrEP) during pregnancy may play a role in preventing HIV acquisition; however, its role in preventing vertical transmission is difficult to elucidate. Substantial progress has been made in recent years to eliminate HIV perinatal transmission. Future research hinges upon a multipronged approach to improving HIV detection, risk-stratified treatment strategies, and prevention of primary HIV infection among pregnant persons.
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