Document 0188
 DOCN  M9550188
 TI    Strategies for prevention of perinatal transmission of HIV infection.
       Siena Consensus Workshop II.
 DT    9505
 SO    J Acquir Immune Defic Syndr Hum Retrovirol. 1995 Feb 1;8(2):161-75.
       Unique Identifier : AIDSLINE MED/95135994
 AB    Worldwide clinical trials are in progress or are being planned to
       evaluate different interventions aimed at reducing transmission of human
       immunodeficiency virus (HIV) from mother to infant. Several new
       therapeutic agents will soon be the focus of clinical trials to evaluate
       their safety for pregnant women and their infants and to test their
       efficacy in preventing perinatal transmission. Identification of the
       factors that influence the timing and mechanism of perinatal HIV
       transmission is essential to the assessment of interventions to reduce
       transmission. An international workshop was held on June 3-6, 1993, in
       Siena, Italy, to review what is known about the risk factors, timing,
       and mechanisms of HIV type 1 (HIV-1) transmission from mother to infant
       during gestation, birth, and lactation. Several possible interventions
       were compared with respect to their mechanism of action, their
       dependence upon the mode and timing of perinatal HIV transmission, and
       their suitability for incorporation into trials, alone or in
       combination, in various parts of the world. Obstetrical interventions
       such as caesarian section or use of a virucidal vaginal lavage during
       labor, administration of antiretroviral drugs to mother and/or infant,
       as well as active and/or passive immunization were discussed. The role
       of breast-feeding in perinatal HIV infection and in the trials was also
       evaluated. Because the ability to enroll pregnant, HIV-infected women in
       trials is limited, it is essential that proposed trials be carefully
       evaluated for adequacy of the sample size, appropriateness of the type
       of intervention to the particular population of women to be enrolled,
       and feasibility of the intervention. Worldwide coordination of perinatal
       intervention trials is essential to prevent duplication, allow the
       optimal use of human and financial resources, and ensure the most rapid
       possible evaluation and implementation of means to prevent pediatric HIV
       infection.
 DE    Antibodies, Viral  Antiviral Agents/THERAPEUTIC USE  AIDS Vaccines
       Clinical Trials  Delivery/METHODS  *Disease Transmission, Vertical
       Female  Fetus  Human  HIV Infections/EPIDEMIOLOGY/IMMUNOLOGY/*PREVENTION
       & CONTROL/  *TRANSMISSION  Immunotherapy, Adoptive  Infant, Newborn
       Maternal-Child Nursing  Maternal-Fetal Exchange  Pregnancy  Reverse
       Transcriptase/ANTAGONISTS & INHIB  Risk Factors  Support, Non-U.S. Gov't
       CONSENSUS DEVELOPMENT CONFERENCE  JOURNAL ARTICLE  REVIEW

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