ABSTRACT
Since 1994, following the publication of the ACTG 076 trial (AIDS Clinical Trials Groups 076), which demonstrated that zidovudine given ante partum and intra partum to the mother and to the newborn for six weeks, reduced the risk of maternal-infant HIV transmission by 68% (Connor 1994), antiretroviral therapy has been routinely used in resource-rich settings and more and more in resource-limited countries to prevent mother-to-child transmission (MTCT) of HIV. The effi ciency of strategies to reduce MTCT of HIV further improved with the introduction of highly active antiretroviral therapy (HAART), the use of elective caesarean delivery when necessary and the recommendation not to breastfeed. Transmission rates of HIV-1 decreased dramatically in the industrialised world from 20-25% in the early 1990s to around 1% in recent years (Mandelbrot
2001, Townsend 2008). HAART involving a potent combination of at least three antiretrovirals is now the standard of care in HIV-infected pregnant women and combinations of two nucleoside reverse transcriptase inhibitors (NRTIs) and a protease inhibitor (PI) are now recommended and used in resource-rich settings.
