Zorrilla C D
Obstetrics and Gynecology Department, University of Puerto Rico, Rio Piedras.
P R Health Sci J. 2000 Mar;19(1):29-34.
During the past five years there have been significant advances in the knowledge of the factors that affect mother-to-infant HIV-1 transmission. Diverse interventions have been designed and proven effective in reducing the risk of such transmission. In reviewing the pivotal literature in such respect implications for public policy are also analyzed. Because of the constant evolution of the interventions, the public policies also need constant revisions. The impact of viral load assessment during pregnancy and its relationship to transmission risks is discussed, as well as the effectiveness of elective Caesarean delivery. The latter has both positive and negative aspects which merit consideration. Newer approaches, such as highly active anti retroviral therapies (HAART), which have shown to decrease the AIDS mortality, have also shown zero transmission in small cohorts. Shorter and cheaper interventions are also somewhat effective and are good alternatives to resource poor countries.
在过去五年里，人们对影响母婴HIV-1传播的因素的认识有了重大进展。已经设计出多种干预措施，并证明这些措施在降低此类传播风险方面是有效的。在回顾这方面的关键文献时，还分析了对公共政策的影响。由于干预措施不断演变，公共政策也需要不断修订。文中讨论了孕期病毒载量评估的影响及其与传播风险的关系，以及选择性剖宫产的有效性。选择性剖宫产有积极和消极两个方面，值得考虑。更新的方法，如高效抗逆转录病毒疗法（HAART），已显示可降低艾滋病死亡率，在小群体中也显示出零传播。更短、更便宜的干预措施也有一定效果，是资源匮乏国家的良好替代方案。
