Mother-to-Infant Transmission of the Human Immunodeficiency Virus during Primary Infection

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Abstract
The efficacy of antiretroviral-drug therapy in preventing mother-to-infant transmission of the human immunodeficiency virus (HIV) has led to the recommendation of universal testing of pregnant women as early as possible after conception.1 However, this strategy precludes the identification of women who acquire HIV infection later in pregnancy, including women who are infected during the peripartum period. Either scenario can result in erroneous exclusion of infant HIV infection, as has been documented for congenital syphilis.2 Early identification of infants with HIV infection is important for the initiation of prophylaxis against Pneumocystis carinii pneumonia and antiretroviral-drug therapy. We report a case of perinatal HIV infection that occurred during the period in which the mother was seronegative and that was further distinguished by the infant's rapid progression to AIDS and death without the development of detectable HIV antibodies.

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