Prophylactic antiretroviral regimens for prevention of mother-to-child transmission of HIV in resource-limited settings. - Inserm - Institut national de la santé et de la recherche médicale Accéder directement au contenu
Article Dans Une Revue Current Opinion in HIV and AIDS Année : 2008

Prophylactic antiretroviral regimens for prevention of mother-to-child transmission of HIV in resource-limited settings.

Résumé

PURPOSE OF REVIEW: With the large international mobilization against HIV/AIDS, more HIV-infected people in resource-limited settings have access to antiretroviral therapy, including pregnant women. The relevance of simplified prophylactic antiretroviral regimens for the prevention of mother-to-child transmission of HIV may become questionable due to their lower efficacy and their higher risk of inducing viral resistance than fully suppressive antiretroviral therapy. RECENT FINDINGS: Field implementation of current recommendations, impact of prophylactic regimens on subsequent antiretroviral therapy response and possible new indications of antiretroviral therapy in pregnant women will be reviewed in this paper. SUMMARY: Prophylactic antiretroviral prevention of mother-to-child transmission regimens reached only 10% of the HIV-infected pregnant women in 2006, who were usually offered single-dose nevirapine only. The operational links between antenatal care and antiretroviral therapy programmes can now be documented and demonstrate good results in terms of safety and efficacy. The negative impact of single-dose nevirapine exposure on subsequent first-line antiretroviral therapy appears worse for mothers with advanced HIV disease at the time of delivery and short interval before antiretroviral therapy initiation. Strengthening the links between antenatal care and antiretroviral therapy programmes is critical for antiretroviral therapy-eligible HIV-infected pregnant women in terms of prevention of mother-to-child transmission and subsequent antiretroviral therapy response. The breastfeeding period could be a new indication for antiretroviral therapy in this population.
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Dates et versions

inserm-00253310 , version 1 (13-02-2008)

Identifiants

Citer

Elise Arrivé, François Dabis. Prophylactic antiretroviral regimens for prevention of mother-to-child transmission of HIV in resource-limited settings.. Current Opinion in HIV and AIDS, 2008, 3 (2), pp.161-5. ⟨10.1097/COH.0b013e3282f51b89⟩. ⟨inserm-00253310⟩

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