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|Early identification of HIV-infected women is
crucial for the health of such women and for care of HIV-exposed and
HIV-infected children. Knowledge of maternal HIV infection during the
antenatal period enables
a. HIV-infected women to receive appropriate antiretroviral therapy and prophylaxis against opportunistic infections for their own health;
b. Provision of antiretroviral chemoprophylaxis with ZDV during pregnancy, during labor, and to newborns to reduce the risk for HIV transmission from mother to child [4, 6, 7];
c. Counseling of infected women about the risks for HIV transmission through breastmilk and advising against breastfeeding in the United States and other countries where safe alternatives to breastmilk are available ;
d. Initiation of prophylaxis against Pneumocystis carinii pneumonia (PCP) in all HIV-exposed infants beginning at age 4 to 6 weeks in accordance with PHS guidelines ; and early diagnostic evaluation of HIV-exposed infants to permit early initiation of aggressive antiretroviral therapy in infected infants.
Most HIV infection among children is acquired perinatally, and most perinatal transmission occurs during or near the time of birth, which raises the possibility of initiating treatment in an infected infant during the period of initial (i.e., primary) HIV infection.