HIV transmission from mother to child : HAART compared with dual therapy
There are increasing calls for the use of highly active antiretroviral therapy (HAART) for the prevention of perinatal mother-to-child transmission (PMTCT) of HIV.1 This approach does not recognise the weaknesses in health systems to implement complex treatment protocols. In addition, the safety of HAART during pregnancy is uncertain and the consequences of stopping HAART if not required outside pregnancy are unknown. If the same PMTCT of HIV could be attained with a simple regimen with proven safety and known adverse drug effects, this would be a better option in most under-resourced countries.2 The superiority of HAART compared with dual therapy according to World Health Organization (WHO) recommendations for immune-competent women to reduce PMTCT has not been proven.3 We aimed to determine whether there is a difference in perinatal HIV transmission on HAART therapy compared with the national dual-therapy regimen. In addition, the relation between CD4 counts and transmission in the dual-therapy group was investigated.