School of Global Health.
Center of Excellence for Pediatric Infectious Diseases and Vaccines, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Curr Opin HIV AIDS. 2024 Nov 1;19(6):280-286. doi: 10.1097/COH.0000000000000878. Epub 2024 Jul 16.
To review the latest data on prevention of HIV vertical transmission in Asia and Africa and discuss strategic directions to achieve an AIDS free generation by 2030.
Progress in vertical transmission elimination efforts in Africa and Asia have stalled in the last decade, with 130 000 new infections in 2022. Main causes of vertical transmissions vary; in Asia-Pacific due to its low-burden, thus low testing coverage, but high overall vertical transmission rates, in South and East Africa due to new HIV infections during pregnancy and breast/chestfeeding, whereas in Western and Central Africa due to low antiretroviral therapy (ART) coverage. Long-acting injectable ART and neutralizing antibodies for treatment and prevention show promise in supporting efforts to further reduce vertical transmissions. Integrated and more accessible pre- and postnatal care is needed to achieve an AIDS-free generation.
Much can be implemented to address existing HIV service gaps; including strengthening of HIV prevention services for youth and women of childbearing age and pregnant people, early detection and treatment, and the delivery of integrated services that can reach and retain pregnant and postpartum people living with HIV in care.
回顾亚洲和非洲预防 HIV 母婴垂直传播的最新数据,并讨论到 2030 年实现无艾滋病世代这一目标的战略方向。
在过去十年中,非洲和亚洲在消除母婴垂直传播方面的进展停滞不前,2022 年有 13 万例新的感染。垂直传播的主要原因有所不同;在亚太地区,由于负担较低,因此检测覆盖率较低,但总体垂直传播率较高;在南部和东部非洲,由于怀孕期间和哺乳期新的 HIV 感染;而在西部和中部非洲,由于抗逆转录病毒疗法(ART)覆盖率低。长效注射型 ART 和用于治疗和预防的中和抗体在支持进一步减少母婴垂直传播方面显示出前景。需要提供综合且更易获得的产前和产后护理,以实现无艾滋病世代。
可以采取许多措施来解决现有的 HIV 服务差距;包括加强青少年和育龄妇女以及孕妇的 HIV 预防服务,早期发现和治疗,以及提供综合服务,以接触和留住接受治疗的艾滋病毒母婴。