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Athena P. Kourtis, MD, PhD; Marc Bulterys, MD, PhD; Steven R. Nesheim, MD; Francis K. Lee, PhD

JAMA. 2001;285:709-712.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

INTRODUCTION

Mother-to-infant transmission of human immunodeficiency virus (HIV) occurs, without any intervention, at rates of 14% to 42% in various settings.^1-2 Determining the timing of such transmission is of great clinical relevance for implementing cost-effective prophylaxis.^3-4 Based on virologic detection of HIV during the infant's first 2 days of life, it is generally accepted that about one third of transmissions in nonbreastfeeding women occur during gestation and the remaining two thirds during delivery.^5-9 Further support for the notion that most HIV transmission occurs intrapartum includes the association of transmission with prolonged duration of membrane rupture,^10-12 the protective effect of elective cesarean delivery,^13-16 and a virologic and immunologic pattern of acute primary HIV infection in a majority of affected infants.¹⁷ However, these findings could be explained by transmission either very late in gestation or during . . . [Full Text of this Article]

Perinatal Interventions: Cesarean Delivery

Antiviral Regimens

Interpretation

Concurring Evidence

Conclusions

Author Affiliations: Division of Infectious Diseases, Epidemiology and Immunology, Department of Pediatrics, Emory University School of Medicine (Drs Kourtis, Nesheim, and Lee), and Division of HIV/AIDS Prevention, Surveillance and Epidemiology, Centers for Disease Control and Prevention (Dr Bulterys), Atlanta, Ga.

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