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HIV infection in pregnancy has become the most common complication of pregnancy with over 90% of infections in children resulting from mother to child transmission. Globally almost 600 000 children are infected by mother to child transmission of HIV annually, giving over 1600 each day. The risk of transmission is between 20 and 40%. Transmission can occur in-utero, during labour and delivery or postpartum through breast milk with most transmission occurring in late pregnancy and during labour.
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There have been many recent advances in preventing vertical HIV transmission. The use of anti-retrovirals, caesarian sections and formula feeding (as a replacement for breastfeeding) have been shown to be efficacious in reducing the risk of transmission. 1-5 The 1998 antenatal survey in South Africa revealed that 22.8 % of women attending antenatal clinics were HIV-infected.6 This represents a 33.8 % increase in the national prevalence of HIV infection since 1997. In South Africa the incidence of vertical HIV transmission (from infected mother to child) is at least 30%, and by the year 2001 it is anticipated that 15% of all births will be infants who are HIV positive.
The HIV prevalence in women attending antenatal clinics in the Western Cape was 5.2% in 1998 and considerably higher (12.97%) in Khayelitsha - a peri urban district of Cape Town. A Mother to child HIV prevention pilot program (based on the Thai short course AZT regimen) was implemented in Khayelitsha on the 4th January 1999.
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