Selected key materials

Coutsoudis A, Pillay K, Spooner E et al. Influence of infant-feeding patterns on early mother-to-child transmission of HIV-1 in Durban, South-Africa: a prospective study. Lancet 1999;354:471-76. The authors suggest that exclusive breastfeeding may carry a much lower risk of HIV transmission than mixed feeding.

European Mode of Delivery Collaboration. Elective C-section versus vaginal delivery in prevention of vertical transmission: a randomised clinical trial. Lancet 1999; 353: 1035-39. Analysis of 370 infants on risk of MTCT related to mode of delivery shows that elective C-section significantly lowers the risk of MTCT.

Fawzi WW, Msamanga GI, Spiegelman D et al. Randomized Trial of Effects of Vitamin Supplements on Pregnancy Outcomes and T Cell Counts in HIV-1-Infected Women in Tanzania. The Lancet 1998; 351: 1477-1482. The study results show no effect of vitamin A supplementation on HIV transmission, but a reduction in overall maternal and infant morbidity and mortality.

Guay LA, Musoke P, Fleming T, et al. Intrapartum and neonatal single-dose nevirapine compared with zidovudine for prevention of mother-to-child transmission of HIV-1 in Kampala, Uganda: HIVNET 012 randomised trial. Lancet 1999; 354: 795-802. This paper reports on the efficacy of nevirapine given at a single dose to the mother at onset of labour, and to the infant within 3 days of life.

Marseilles E, Kahn KG, Mmiro F et al. Cost-effectiveness of single-dose nevirapine regimen for mothers and babies to decrease vertical HIV-1 transmission in sub-Saharan Africa. Lancet 1999; 354: 803-809. This analysis compares cost-effectiveness of different antiretroviral regimens for the prevention of MTCT.

Nduati R, John G, Mbori-Ngacha D et al. Effect of breastfeeding and formula feeding on transmission of HIV-&: A randomized clinical trial. JAMA 2000; 283:1167-74. In this randomized trial, 44% of HIV transmissions were found attributable to breastfeeding.

UNAIDS, UNICEF and WHO. HIV and infant feeding. Geneva: UNAIDS, UNICEF, World Health Organisation, 1998. Three modules were published (1) Guidelines for decision-makers (2) A Guide for health care managers and supervisors (3) A review of HIV transmission through breastfeeding. Available on the UNAIDS website at http://www.unaids.org

WHO. Recommendations on the safe and effective use of short-course antiretroviral regimens for the prevention of mother-to-child transmission of HIV. Weekly Epidemiological Record 2000. This paper reviews antiretroviral regimen options to prevent MTCT. Available on the UNAIDS website

WHO and UNAIDS. HIV in pregnancy: A review. UNAIDS/99.35E. Discussion of MTCT risk factors, and of interventions currently available or under study. Available on the UNAIDS website