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The End Is in Sight: Current Strategies for the Elimination of HIV Vertical Transmission

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Abstract

Purpose of Review

The goal of this review is to highlight and interpret recent trends and developments in the diagnosis, treatment, and prevention of HIV vertical transmission from a clinical perspective.

Recent Findings

Universal third-trimester retesting and partner testing may better identify incident HIV among pregnant patients and result in early initiation of antiretroviral therapy to prevent vertical transmission. The proven safety and efficacy of integrase inhibitors such as dolutegravir may be particularly useful in suppressing viremia in pregnant persons who present late for ART treatment. Pre-exposure prophylaxis (PrEP) during pregnancy may play a role in preventing HIV acquisition; however, its role in preventing vertical transmission is difficult to elucidate.

Summary

Substantial progress has been made in recent years to eliminate HIV perinatal transmission. Future research hinges upon a multipronged approach to improving HIV detection, risk-stratified treatment strategies, and prevention of primary HIV infection among pregnant persons.

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Funding

Lanbo Yang was supported by the UCLA South American Program in HIV Prevention Program (PI: Clark), NIMH grant R25MH08722. The funders had no role in contributing to this review.

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Authors and Affiliations

  1. Warren Alpert Medical School, Brown University, 222 Richmond Street, Providence, RI, 02903, USA

    Lanbo Yang

  2. Division of Infectious Diseases, Department of Medicine, UCLA David Geffen School of Medicine, Los Angeles, CA, USA

    Mary Catherine Cambou

  3. Division of Pediatric Infectious Diseases, Department of Pediatrics, UCLA David Geffen School of Medicine, Los Angeles, CA, USA

    Karin Nielsen-Saines

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  1. Lanbo Yang
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  2. Mary Catherine Cambou
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  3. Karin Nielsen-Saines
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Correspondence to Lanbo Yang.

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Yang, L., Cambou, M.C. & Nielsen-Saines, K. The End Is in Sight: Current Strategies for the Elimination of HIV Vertical Transmission. Curr HIV/AIDS Rep 20, 121–130 (2023). https://doi.org/10.1007/s11904-023-00655-z

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