Antiretroviral therapy and interruption of HIV perinatal transmission

In the United States in 1994, a regimen of zidovudine (ZDV)-administered during pregnancy, labor, and to the newborn for the first 6 weeks of life-reduced the risk of HIV perinatal transmission by two-thirds. In general clinical practice, this regimen has been associated with dramatic declines in perinatal transmission in the United States and other industrialized countries. The complexity and cost of the ZDV regimen, however, limits its applicability in many developing countries, in which the majority of perinatal transmission occurs. Modified antiretrovirals and other interventions are currently being tested. Over the next few years, the results of these tests should advance our understanding of the pathogenesis of perinatal HIV-1 transmission, as well as provide alternative interventions to reduce the burden of pediatric HIV infection.