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September 11, 1996

Preventing Perinatal HIV Transmission

Author Affiliations

Washington Hospital Center
George Washington University Washington, DC

JAMA. 1996;276(10):779. doi:10.1001/jama.1996.03540100023012

To the Editor.  —The article by Drs Simonds and Rogers1 is yet another example of the value of human immunodeficiency virus (HIV) therapy in pregnancy. Unfortunately, a significant percentage of women in this country do not know that they are HIV-positive and, thus, the chance to reduce transmission to their infant is lost. We have enrolled 25 HIV-positive pregnant women into various treatment studies such as AIDS [acquired immunodeficiency syndrome] Clinical Trials Group (ACTG) protocol 185 for the last year. To our discomfort and horror, 9 of these patients first became aware of their HIV status by having a prior child admitted to the Children's National Medical Center with an AIDS-defining illness. Six of these children died. Like the canaries carried by coal miners in the previous century whose death would portend the presence of lethal gases, these children are the unfortunate sentinels of undiagnosed HIV infection.There are