Current Problems in Pediatric and Adolescent Health Care
Prevention of Mother-to-Child Transmission of Viral Infections
Introduction
Mother-to-child transmission (MTCT) of viral infections causes significant morbidity and mortality among children. Our understanding of the epidemiology, pathogenesis, diagnosis, and prevention of viral infections transmitted from mothers to children has improved tremendously in recent years. The objectives of this review are to address the epidemiology, diagnosis, and prevention of MTCT of specific viral infections, specifically, human immunodeficiency virus type 1 (HIV), cytomegalovirus (CMV), Herpes simplex virus (HSV), hepatitis B virus (HBV), and hepatitis C virus (HCV).
Section snippets
Background
In the U.S., the seroprevalence of HIV among adults is estimated to be 0.47%.1 At the end of 2007, an estimated 33 million people, including 2.1 million children under the age of 15 years, were living with HIV infection worldwide.2 An estimated 1200 children under the age of 15 years acquire HIV infection each day (420,000 new infections/yr).2
Most children acquire infection with HIV through MTCT.3 Over the past several years, major successes have been achieved in prevention of MTCT. In the
Conclusions
The estimated prevalence among adults of these five viral infections varies considerably (from less than 1% to 60%) (Table 11). Similarly, the risk of MTCT ranges from less than 1% to 50%. Transmission can occur during pregnancy, around the time of labor and delivery, or postnatally through breast milk (although HBV and HCV have not been demonstrated to be transmitted through breast milk), and, in general, most transmission occurs during the intrapartum period. Primary prevention is important
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The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention or the National Institutes of Health.
The authors have no commercial associations, current and within the past 5 years, that might pose a potential, perceived, or real conflict of interest.