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Cohort study
Women with HIV infection on antiretroviral therapy with low viral loads can safely opt for vaginal delivery in the absence of obstetrical risk factors
  1. Michael K Lindsay
  1. Emory University School of Medicine, Atlanta, Georgia, USA
  1. Correspondence to: Dr Michael K Lindsay, Emory University School of Medicine, 69 Jessie Hill Jr Drive SE, Atlanta, GA 30303, USA; mlindsa{at}

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The risk of mother-to-child HIV transmission (MTCT) is related to the infant's exposure to HIV-infected maternal blood during birth. Studies published in 1999 have shown a protective effect from elective caesarean section (ECS) in reducing the risk of MTCT.1 ,2 However, these studies were conducted prior to use of combination antiretroviral therapy (cART) in pregnancy becoming widespread. Antiretroviral therapy through maximum suppression of maternal viral load is the most effective means of preventing MTCT.3 Whether there is any additional benefit from ECS for mothers with …

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