July 30th, 2010

Perinatal Transmission of HIV “Solved” — Now How Do We Pay For It?

mother and babyConspicuously absent from this year’s International AIDS Conference were major studies on prevention of maternal-to-child transmission.

It could be that I just missed them, so I emailed a colleague who specializes in the area, and she concurred:

Nope, did not see or hear major PMTCT updates at IAS.

The thing is, this problem has been all but solved, at least scientifically.  Put the mom on fully suppressive treatment, and the rest of what is done barely matters — mode of delivery, HIV treatment to the baby, breast vs formula feeding.  It’s all a wash, because HIV transmission will barely ever occur.

(Yes, there are numerous other questions unrelated to HIV transmission, most notably the safest regimens from the perspective of in-utero exposure.  Bold prediction:  one day we will no longer be using zidovudine.)

So — now that we know what to do (treat the moms), we just have to learn how to pay for it.  Easier said than done.

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HIV Information: Author Paul Sax, M.D.

Paul E. Sax, MD

Contributing Editor

NEJM Journal Watch
Infectious Diseases

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