Trends in human immunodeficiency virus (HIV) counseling, testing, and antiretroviral treatment of HIV-infected women and perinatal transmission in North Carolina

Since 1993, trends in perinatal human immunodeficiency virus (HIV) transmis sion have been monitored by use of chart review of patients identified at a central diagnostic laboratory. In the population studied, either pre- or p ostnatal antiretroviral therapy to the infant increased from 21% in 1993 to 95% in 1997, Concurrently, the number of HIV-infected infants declined fro m 25 in 1993 to 4 in 1997, The complete Pediatric AIDS Clinical Trials Grou p Protocol 076 regimen was the most effective in reducing transmission (3.1 %). Twenty-two of 35 infants who became infected in 1995-1997 had mothers w ho did not receive antiretroviral therapy, although counseling practices im proved with time. In 1995, 87% of the mothers of HIV-seropositive infants w ere counseled, whereas in 1997, 96% were counseled (P<.005), None of 59 inf ants tested had high-level phenotypic zidovudine resistance, although 5 (8. 8%) of 57 infants had virus isolates with at least one mutation in the reve rse transcriptase gene associated with reduced phenotypic susceptibility to zidovudine.