PREVENTING PERINATAL HIV TRANSMISSION - ZIDOVUDINE USE DURING PREGNANCY

Human immunodeficiency virus (HIV) infection and acquired immunodefici ency syndrome in women of childbearing age are increasing rapidly in t he United States. Perinatal transmission can occur during pregnancy, d elivery or breast feeding. Because 90 percent of pediatric HIV infecti ons are caused by perinatal transmission, the U.S. Public Health Servi ce has recommended that all pregnant women be offered HIV counseling a nd testing. Factors that influence perinatal transmission include high maternal viral load, low maternal CD4 count, prolonged rupture of the membranes, premature delivery and symptomatic maternal HIV infection. The results of a recent clinical trial demonstrate that if HIV-infect ed women become pregnant, the use of zidovudine during the prenatal, i ntrapartum and neonatal periods can decrease by two-thirds the likelih ood of HIV transmission to the baby. The U.S. Public Health Service, i n conjunction with the American Academy of Family Physicians, has stro ngly recommended expanding the current noncoercive, voluntary HIV test ing to include routine testing of all pregnant women.