Vertical infection of human immunodeficiency virus as an imported infectious disease

Background and methods: In Japan, 26 children who vertically acquired human immunodeficiency virus (HIV) infection had been reported as at February 1997. Little information was published about their epidemiological backgrounds and the rate of perinatal HIV transmission in Japan remains unknown. To learn the epidemiological features of perinatal HIV infection in Japan, we examined the medical records of five perinatally infected children. Results: Three of five mothers were Japanese and two others were South East Asian. Four of them acquired HIV infection abroad and one became infected through her spouse who had acquired infection abroad. Therefore, HIV infection in these five cases can be regarded as an imported infectious disease. None of the five mothers noticed their HIV infection before their pregnancy. One mother was found to be HIV seropositive during her pregnancy, but the others did not notice their HIV infection until their delivery. Conclusions: To reduce the incidence of perinatally HIV-infected children it is necessary to lower the incidence of mother-to-infant HIV transmission. In Western countries they have succeeded in reducing the risk for perinatal HIV transmission with perinatal zidovudine therapy. To prescribe the preventive therapy against perinatal HIV transmission, it is essential to know if pregnant women are infected with HIV or not. Therefore, women of childbearing age should accept voluntary prenatal HIV testing. At the same time, they should be offered such programs that can enable them to receive timely counseling, besides medical treatment, if they are found to be HIV infected.