Guidelines of antiretroviral therapies for preventing mother-to-child transmission of HIV: to promote the development and dissemination of evidence-based guidelines

Article type
Authors
Wang L, Peng L, Sun X, Du L, Li Y
Abstract
Objectives: To identify and assess guidelines of peripartum antiretroviral therapies (ART) for preventing mother-to-child transmission (MTCT) of HIV.
Methods: We searched PubMed, EMBASE, CINAHL, AID Search, AIDS LINE, AIDSTRIALS, AIDSDRUGS, AIDS info and the Chinese Databases (CBM, CNKI, VIP) from the beginning of the databases to Dec.31, 2006. The Cochrane Library (2006 issue 4), websites of WHO, UNAIDS, CDC, and Ministries of Health from different countries, and related websites of guidelines (such as NICE, SIGN, National Guideline Clearinghouse, EBM guidelines, etc.) were also searched.
Results: Sixty-nine guidelines or recommendations were included which were published by WHO, CDC, Ministries of Health, and other academic societies (e.g. International AIDS Society, American Academy of Pediatrics, Canadian HIV Trials Network Antiretroviral Working Group, AIDS Society of India, British HIV Association, and Irish Infection Society) since 1994. Less than half of the guidelines (32/69) were specific guidelines of ART for preventing MTCT, and the remaining are guidelines for treatment of adults or children with HIV infections, a few of which include prevention of MTCT. More than 75% of these guidelines had been released from developed countries, while fewer guidelines were published from low and middle-income countries, such as South Africa, India and China. Most national guidelines were updated over time for emerging evidence. WHO released and updated the guideline 'Antiretroviral drugs for antiretroviral for treating pregnant women and preventing HIV infection in infants in resource-limited settings: towards universal access' in 2006, which is recommended around the world.
Conclusions: Guidelines of ART for preventing MTCT of HIV have been developed by WHO and most developed countries, while limited guidelines were recommended in developing countries. The guidelines should be developed in resource-limited countries by combining the best evidence and context of socio-economic conditions.