Centre for Maternal and Child Health Research, University of KwaZulu-Natal, Durban, South Africa.
Curr Opin HIV AIDS. 2008 Mar;3(2):180-5. doi: 10.1097/COH.0b013e3282f50bda.
At a time when highly effective drugs to prevent peripartum transmission of HIV are readily available and affordable, HIV remains the single most important cause of the death of infants and young children in southern and east Africa.
Evidence from the past 5 years highlights four main points. The survival of children born to HIV-infected mothers relies on the mothers remaining well and alive. Suboptimal feeding practices of HIV-exposed infants can significantly increase infant mortality aside of any impact on postnatal transmission of HIV. Antiretroviral drugs are now available that can reduce morbidity and mortality in infected women as well as the transmission of HIV to their infants. Finally, the inability of health systems to deliver prevention of mother-to-child transmission services is the greatest obstacle to reducing HIV infection among infants and improving maternal and child survival.
The goal of improved maternal and child survival and not just the avoidance of HIV infection in infants must be the goal of prevention of mother-to-child transmission programmes. Research is needed to identify interventions that will improve the ability of health systems to deliver prevention of mother-to-child transmission services in addition to new and more effective therapeutic interventions.
综述目的：在可获得和负担得起高效预防围产期母婴传播 HIV 药物的时代，HIV 仍然是南部和东部非洲婴儿和幼儿死亡的首要原因。
最新发现：过去 5 年的证据强调了以下四点。感染 HIV 的母亲所生儿童的存活依赖于母亲保持健康和存活。除了对 HIV 产后传播的影响外，HIV 暴露婴儿的喂养方式不佳会显著增加婴儿死亡率。现在有抗逆转录病毒药物可以降低感染妇女的发病率和死亡率，以及 HIV 向婴儿的传播。最后，卫生系统无法提供母婴传播预防服务，这是降低婴儿 HIV 感染率和改善母婴生存的最大障碍。
总结：改善母婴生存的目标，而不仅仅是避免婴儿感染 HIV，必须是母婴传播预防规划的目标。需要研究确定除了新的、更有效的治疗干预措施之外，还能提高卫生系统提供母婴传播预防服务的能力的干预措施。
