Risk Factors for Perinatal HIV-1 Transmission in Pregnant Women Requiring Lifelong Antiretroviral Therapy: A Longitudinal Study at a Tertiary Hospital in South Africa (Research) (Human Immunodeficiency Virus) (Report‪)‬

Paediatric HIV-1 infection has virtually been eradicated in resource-rich countries, largely owing to the provision of multidrug combination antiretroviral therapy (ART) to all HIV-1-infected pregnant women, elective caesarean section (ELCS), and avoidance of breastfeeding. Currently fewer than 200 infants are born with HIV-1 infection annually in the USA, and fewer than 250 in Western Europe. (1,2) In contrast, sub-Saharan Africa bears much of the burden of worldwide infant HIV-1 infections--in 2008 almost 90% of the estimated 390 000 new paediatric infections occurred in this part of the world. (3) Factors associated with perinatal HIV-1 transmission include the administration of ART, maternal CD4 count, maternal plasma HIV-1 RNA viral load (VL) at delivery, preterm birth, mode of delivery, and prolonged rupture of the membranes prior to delivery. (4-10)