India has a huge burden of maternally transmitted HIV. There are unique socio-cultural, economic, nutritional and system issues which require different approaches and solutions. This article summarizes the major research issues and gaps in knowledge in the Indian set-up,
Draft Treatment Guidelines for Pediatricians on HIV care and treatment including ART.NACO, March 2006.
2.
ShahNK, MehtaK, ManglaniMV.Prevention of mother to child transmission of HIV. Ind J Pract Pediatr2003; 5(4): 337–347.
3.
De CockKM, FowlerMG, MercierE, de VincenziI, SabaJ, HoffE, AlnwickDJ, RogersM, ShafferN.Prevention of mother-to-child HIV transmission in resource-poor countries: translating research into policy and practice. JAMA.2000; 283:1175–82
4.
LallemantM, JourdainG, Le CoeurS, MaryJY, Ngo-Giang-HuongN, KoetsawangS, KanshanaS, McintoshK, ThaineuaV; Perinatal HIV Prevention Trial (Thailand) Investigators. Single-dose perinatal nevirapine plus standard zidovudine to prevent mother-to-child transmission of HIV-1 in Thailand. N Engl J Med.2004;351: 217–28.
5.
VolminkJ, SiegfriedNL, van der MerweL, BrocklehurstP.Antiretrovirals for reducing the risk of mother-to-child transmission of HIV infection. Cochrane Database Syst Rev.2007, (1):CD003510
6.
ReadJS, NewellMK.Efficacy and safety of cesarean delivery for prevention of mother-to-child transmission of HIV-1. Cochrane Database Syst Rev.2005, (4):. CD005479.
7.
HorvathT, MadiBC, luppaIM, KennedyGE, RutherfordG, ReadJS.Interventions for preventing late postnatal mother-to-child transmission of HIV. Cochrane Database Syst Rev.2009; (1):CD006734.
8.
Perinatal HIV Guidelines Working Group.Public Health Service Task Force Recommendations for Use of Antiretroviral Drugs in Pregnant HIV-infected Women for Maternal Health and Interventions to Reduce Perinatal HIV Transmission in the United States. April 29, 2009; pp 1–90. Available at http://aidsinfo.nih.gov
9.
Petra Study Team.Efficacy of three short-course regimens of zidovudine and lamivudine in preventing early and late transmission of HIV-1 from mother to child in Tanzania, South Africa, and Uganda (Petra study): a randomised, double-blind, placebo-controlled trial. Lancet2002. 359 (9313):1178–86.
10.
DorenbaumA, CunninghamCK, GelberRD. Two-dose intrapartum/newborn nevirapine and standard antiretroviral therapy to reduce perinatal HIV transmission: a randomized trial. JAMA, 2002. 288(2):189–98.
11.
LallemantM, JourdainG, Le CoeurS. Single-dose perinatal nevirapine plus standard zidovudine to prevent mother-to-child transmission of HIV-1 in Thailand. N Engl J Med, 2004. 351(3):217–28
12.
Working Group on Antiretroviral Therapy and Medical Management of HIV-infected Children.Guidelines for the Use of Antiretroviral Agents in Pediatric HIV Infection. Rockville, MD: US Department of Health and Human Services; 2008. Available at: http://aidsinfo.nih.gov/ContentFiles/PediatricGuidelines.pdf. Accessed July 2, 2008
13.
McIntyreJA, HopleyM, MoodleyD, Eklund Efficacy of short-course AZT plus 3TC to reduce nevirapine resistance in the prevention of mother-to-child HIV transmission: a randomized clinical trial. PLoS Med. 2009 Oct;6(10):e1000172. Epub 2009 Oct 27
14.
BrocklehurstP, VolminkJAntiretrovirals for reducing the risk of mother-to- child transmission of HIV infection CochraneDatabase Syst Rev2007;(1):CD003510 updated
15.
LallemantM, JourdainG, Le CoeurS. A trial of shortened zidovudine regimens to prevent mother-to-child transmission of human immunodeficiency virus type 1. Perinatal HIV Prevention Trial (Thailand) Investigators. N Engl J Med, 2000. 343(14):982–91. http://www.ncbi.nlm.nih.gOv/pubmed/11018
16.
TraisathitP, MaryJY, Le CoeurSRisk factors of preterm delivery in HIV-infected pregnant women receiving zidovudine for the prevention of perinatal HIV. J Obstet Gynaecol Res.2009 Apr;35(2):225–33.
17.
Six Week Extended-Dose Nevirapine (SWEN) Study Team, BedriA, GudettaB. Extended-dose nevirapine to 6 weeks of age for infants to prevent HIV transmission via breastfeeding in Ethiopia, India, and Uganda: an analysis of three randomized controlled trials. Lancet2008; 372(9635):300
18.
KumwendaNl, HooverDR, MofensonLM. Extended antiretroviral prophylaxis to reduce breast-milk HIV-1 transmission. N Engl J Med, 2008. 359(2):119–29.
19.
ThiorI, LockmanS, SmeatonLM, ShapiroRL, Wester Breastfeeding plus infant zidovudine prophylaxis for 6 months vs formula feeding plus infant zidovudine for 1 month to reduce mother-to-child HIV transmission in Botswana: a randomized trial: the Mashi Study. JAMA.2006 Aug 16;296(7):794–805.
20.
KilewoC, KarlssonK, NgarinaM. Prevention of mother to child transmission of HIV-1 through breastfeeding by treating mothers prophylactically with triple antiretroviral therapy in Dar es Salaam, Tanzania – the MITRA PLUS study. 4th IAS Conference on HIV Pathogenesis, Treatment and Prevention; July 22–25, 2007; Sydney, Australia. Abstract TuAX101, page 96
21.
ArendtV. AMATA study: effectiveness of antiretroviral therapy in breastfeeding mothers to prevent post-natal vertical transmission in Rwanda. Fourth International AIDS Society Conference on HIV Treatment and Pathogenesis, Sydney, abstract TuAX102, 2007
22.
HIV transmission through breastfeeding – A review of available evidence- an update from 2001–2007 –WHO
23.
ThomasT, MasabaR, NdivoR. PMTCT of HIV-1 among mothers using HAART: the Kisumu Breastfeeding Study, Kisumu, Kenya 2003–2007. 15th Conference on Retroviruses and Opportunistic Infections; February 3-6, 2008; Boston, MA Abstract 45aLB TuAX010, page 87.
24.
BrysonY, StekA, MirochnickM. Pharmacokinetics, antiviral activity and safety of nelfinavir (NFV) in combination with ZDV/3TC in pregnant HIV-infected women and their infants: PACTG 353 Cohort 2. 9th Conference on Retroviruses and Opportunistic Infections; February 24–28, 2002; Seattle, WA. Abstract 795-W. http://www.retroconference.org/2002/
25.
KramerMS. (2001). Promotion of Breastfeeding Intervention Trial (PROBIT): a randomized trial in the Republic of Belarus. Journal of the American Medical Association, 285(4):413–420.
26.
CapparelliEV, MirochnickM, DanknerWM. Pharmacokinetics and tolerance of zidovudine in preterm infants. J Pediatr.2003;142(1):47–52
27.
Centers for Disease Control and Prevention.Revised Surveillance Case Definitions for HIV Infection Among Adults, Adolescents, and Children Aged _18 Months and for HIV Infection and AIDS Among Children Aged 18 Months to _13 Years–United States, 2008. MMWR Morb Mortal Wkly Rep. 2008; 57 (RR-10, December 5, 2008): 1–16
28.
ReadJS; American Academy of Pediatrics, Committee on Pediatric AIDS. Diagnosis of HIV-1 infection in children younger than 18 months in the United States. Pediatrics.2007; 120(6).
29.
HavensPL, MofensonLM.Committee on Pediatric AIDS Evaluation and Management of the Infant Exposed to HIV-1 in the United States Pediatrics2009;123: 175–87.
30.
LuzuriagaK, SullivanJL.DNA polymerase chain reaction for the diagnosis of vertical HIV infection. JAMA.1996; 275(17):1360–1361
31.
44) DunnDT, BrandtCD, KrivineA. The sensitivity of HIV 1 DNA polymerase chain reaction in the neonatal period and relative contributions of intrauterine & intrapartum transmission. AIDS1995; 9: F7–F11
32.
ObaroSK, LosikoffP, HarwellJ, PugatchD.Failure of serial human immunodeficiency virus type 1 DNA polymerase chain reactions to identify human immunodeficiency virus type 1 clade A/G. Pediatr Infect Dis J.2005; 24(2): 183–184
33.
GerettiAM.HIV-1 subtypes: epidemiology and significance for HIV management. Curr Opin Infect Dis.2006;19(1):1–7
34.
ZhangQ, WangL, JiangY, Fang Early infant human immunodeficiency virus type 1 detection suitable for resource-limited settings with multiple circulating subtypes by use of nested three-monoplex DNA PCR and dried blood spotsJ Clin Microbiol.2008 Feb;46(2): 721–6
35.
YoungNL, ShafferN, ChaowanachanT. Early diagnosis of HIV 1 infected infants in Thailand using RNA & DNA PCR assays sensitive to non B subtypes. J Acquir Immune Defic syndr.2000; 24: 401–407
36.
NesheimS, PalumboP, SullivanK. Quantitative RNA testing for diagnosis of HIV-infected infants. J Acquir Immune Defic Syndr.2003; 32(2):192–195
37.
HumphreyJH, lliffPJ, MarindaET, MutasaKEffects of a single large dose of vitamin A, given during the postpartum period to HIV-positive women and their infants, on child HIV infection, HIV-free survival, and mortality. J Infect Dis.2006 Mar 15;193(6):860–71
38.
GoldblumRM, DillCW: Rapid high temperature treatment of human milk, J Pediatr; 1984; 104: 380
39.
Israel-BallardK, DonovanR, ChantryC.Flash-heat inactivation of HIV-1 in human milk: a potential method to reduce postnatal transmission in developing countriesJ Acquir Immune Defic Syndr.2007 Jul 1;45(3):318–23.
40.
Israel-BallardKA, AbramsBF, Coutsoudis A Vitamin content of breast milk from HIV-1-infected mothers before and after flash-heat treatment. J Acquir Immune Defic Syndr.2008 Aug 1;48(4):444–9.
41.
Israel-BallardK, ChantryC, DeweyK, Lönnerdal Viral, nutritional, and bacterial safety of flash-heated and pretoria-pasteurized breast milk to prevent mother-to-child transmission of HIV in resource-poor countries: a pilot studyJ Acquir Immune Defic Syndr.2005 Oct 1;40(2):175–81
42.
UrdanetaS. (2005). Inactivation of HIV in breast milk by treatment with the alkyl sulfate - microbicide sodium dodecyl sulfate (SDS). Retrovirology, 2(1):28
43.
O'DonovanD, AriyoshiK, MilliganP.Maternal plasma viral RNA levels determine marked differences in mother-to-child transmission rates of HIV-1 and HIV-2 in the Gambia. MRC/ Gambia Government/University College London Medical School Working Group on Mother-Child Transmission of HIV. AIDS.2000;14(4):441–448.