Bulterys M, Lepage P
Department of Family and Community Medicine, University of New Mexico School of Medicine, Albuquerque 87131-5267, USA.
Curr Opin Pediatr. 1998 Apr;10(2):143-50. doi: 10.1097/00008480-199804000-00005.
The first children with HIV-1 infection were described in 1983. As of 1998, the global HIV epidemic is having a profound impact on the health and survival of children. Almost all HIV infections among young children are due to vertical transmission, and the intrapartum period appears to provide us with a crucial window of opportunity for prevention. Postnatal transmission through breastfeeding also contributes an estimated one third to one half of vertical transmission worldwide. Carefully conducted epidemiologic studies are elucidating the immunologic, virologic, and behavioral factors affecting the risk of HIV-1 transmission from mother to infant and the natural history of HIV disease in perinatally infected children. Transmission of HIV-1 is influenced by many factors, and a high maternal viral load is insufficient to fully explain vertical transmission of HIV-1. Pediatricians and other providers should counsel HIV-infected women about the means available to decrease the risk of HIV transmission to the infant. However, the majority of HIV-infected children are born in the developing world, and a crucial challenge is to identify safe and effective interventions that are feasible in those countries with the most significant HIV burden.
首批感染人类免疫缺陷病毒1型（HIV-1）的儿童于1983年被报道。截至1998年，全球HIV流行对儿童的健康和生存产生了深远影响。幼儿中几乎所有的HIV感染都归因于垂直传播，而分娩期似乎为我们提供了一个关键的预防机会窗口。在全球范围内，通过母乳喂养进行的产后传播估计也占垂直传播的三分之一到二分之一。精心开展的流行病学研究正在阐明影响HIV-1从母亲传播给婴儿的风险以及围产期感染儿童HIV疾病自然史的免疫、病毒学和行为因素。HIV-1的传播受多种因素影响，母亲的高病毒载量不足以完全解释HIV-1的垂直传播。儿科医生和其他医疗服务提供者应就可降低HIV传播给婴儿风险的可用方法向感染HIV的女性提供咨询。然而，大多数感染HIV的儿童出生在发展中世界，一项关键挑战是确定在那些HIV负担最重的国家可行的安全有效的干预措施。
