Mode of Delivery and the Risk of Vertical Transmission of HIV-1

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Abstract
The meta-analysis reported by the International Perinatal HIV Group (April 1 issue)1 provides convincing evidence that the risk of transmission of human immunodeficiency virus type 1 (HIV-1) may be further reduced by elective cesarean delivery in women who are receiving either no antiretroviral agents or zidovudine alone. The authors advise caution, pointing out the shortcomings of this analysis, including potential morbidity. They also note, as do Riley and Greene in their editorial,2 the lack of data on viral load and on women receiving highly active antiretroviral therapy.