***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective : To describe pregnancy outcomes among clade C HIV-infected and uninfected women in South Africa . Design : A longitudinal cohort study . Methods : Pregnant women attending 9 rural/urban antenatal clinics were prospect ively recruited and followed up . Women were seen at the clinic or at home after delivery on 4 occasions after enrollment : 2 times within the first 2 weeks of the newborn 's life at home , and every 2 weeks thereafter until their first health clinic visit when the infant was 6 weeks old . Results : A total of 3465 women were enrolled ; 615 withdrew after delivery , moved away , or had a missing or indeterminate HIV status , leaving 2850 women ( 1449 HIV-infected women ) . Six women died after delivery and there were 17 spontaneous abortions and 104 stillbirths . An adverse pregnancy outcome was independently associated with HIV infection ( adjusted odds ratio [ AOR ] = 1.63 ; P = 0.015 ) , urban enrollment ( AOR = 0.39 ; P = 0.020 ) , and nonhospital delivery ( AOR = 13.63 ; P < 0.001 ) as well as with a CD4 count < 200 cells/mL among HIV-infected women ( AOR = 1.86 ; P = 0.127 ) . Among 2529 singleton liveborn babies , birth weight was inversely associated with maternal HIV ( AOR = 1.45 ; P = 0.02 ) and maternal middle upper arm circumference ( AOR = 0.93 ; P < 0.001 ) . Early infant mortality was not significantly associated with maternal HIV ( hazard ratio [ HR ] = 1.18 ; P = 0.52 ) but was with urban sites ( HR = 0.34 ; P = 0.045 ) . Low birth weight substantially increased mortality ( AOR = 8.3 ; P < 0.001 ) . HIV status of infants by 8 weeks of age ( 14.6 % , 95 % confidence interval : 12.5 % to 17.0 % ) was inversely associated with maternal CD4 cell count and birth weight .  Conclusions : HIV-infected women are at a significantly increased risk of adverse pregnancy outcomes . Low-birth-weight infants of HIV-infected and uninfected women are at substantially increased risk of dying Objectives To study mortality in African children born to HIV-1-infected mothers exposed peripartum to zidovudine .  Methods A r and omized placebo-controlled trial in Abidjan and Bobo-Dioulasso . Pregnant women received either 300 mg zidovudine twice daily from 36–38 weeks ’ gestation , 600 mg during labour , and 300 mg twice daily for 7 days post-partum or a matching placebo . Determinants of mortality were studied up to 18 months , overall and among the infected children : treatment , centre , timing of infection , mother and child HIV disease . Results There were 75 infant deaths among 407 live births .  The risk of death at 18 months was 176/1000 in the zidovudine arm and 221 for placebo . Relative hazard ( RH , zidovudine versus placebo ) was 0.47 [ 95 % confidence interval ( CI ) 0.2–1.0 ] up to 230 days of life . Maternal CD4 lymphocyte count < 200/mm3 ( RH 2.92 ; CI 1.4–6.1 ) and child HIV-1 infection ( RH 12.6 ; CI 6.6–24.3 ) increased mortality of all children born to HIV-1-infected mothers . There were 101 children infected ( 40 in the zidovudine group ) , and 51 died . Their 18 month probability of death was 590/1000 in the zidovudine group and 510 in the placebo group . Among infected children , maternal zidovudine reduced the risk of death on or before day 230 ( RH 0.18 ; CI 0.1–0.5 ) . Maternal CD4 lymphocyte count < 200/mm3 ( RH 3.25 ; CI 1.3–8.4 ) , maternal death ( RH 9.65 ; CI 1.7–56.0 ) , diagnosis of paediatric infection on or before day 12 ( RH 18.1 ; CI 4.8–69.0 ) and between days 13 and 45 ( RH 7.63 ; CI 2.0–29.5 ) , clinical paediatric AIDS ( RH 5.37 ; CI 2.3–12.7 ) were risk factors for death in HIV-1-infected children . Conclusion Mother-to-child transmission reduction by zidovudine is safe and beneficial to African children . The mortality of HIV-1-infected children is high . Peripartum maternal zidovudine exerts a protective effect for at least 8 months Objective : Previous studies on the operational effectiveness of programmes to reduce transmission of HIV from mother-to-child ( PMTCT ) in Africa have generally been hospital-based pilot studies with short follow-up periods . Method : Prospect i ve cohort study to evaluate the routine operational effectiveness of the South African National PMTCT Programme , primarily measured by HIV-free survival at 36 weeks post-delivery . Three of eighteen pilot sites participating in the programme were selected as they reflected differences in circumstances , such as HIV prevalence , socioeconomic status and rural – urban location . A total of 665 HIV-positive mothers and their infants were followed . Results : HIV-free survival at 36 weeks varied significantly across sites with 84 % in Paarl , 74 % in Umlazi and 65 % in Rietvlei ( P = 0.0003 ) . Maternal viral load was the single most important factor associated with HIV transmission or death [ hazard ratio ( HR ) , 1.54 ; 95 % confidence interval ( CI ) , 1.21–1.95 ] . Adjusting for health system variables ( fewer than four antenatal visits and no antenatal syphilis test ) explained the difference between Rietvlei and Paarl ( crude HR , 2.27 ; 95 % CI , 1.36–3.77 ; adjusted HR , 1.81 ; 95 % CI , 0.93–3.50 ) . Exposure to breastmilk feeding explained the difference between Umlazi and Paarl ( crude HR , 1.74 ; 95 % CI , 1.06–2.84 ; adjusted HR , 1.41 ; 95 % CI , 0.81–2.48 ) . Conclusion : Ever breastfeeding and underlying inequities in healthcare quality within South Africa are predictors of PMTCT programme performance and will need to be addressed to optimize PMTCT effectiveness OBJECTIVES To identify potential predictors of mortality , to determine mortality rate and to identify prevalent causes of death in a cohort of HIV-1 exposed uninfected infants . DESIGN Prospect i ve cohort study . SETTING Kenyatta National Hospital , Nairobi , Kenya . SUBJECTS Three hundred and fifty one HIV-1 exposed uninfected post-neonatal infants who survived to one year of age . RESULTS Sixteen infants died ( post-neonatal mortality rate of 47/1000 live births ) , 14 ( 88 % ) before six months of age . The most frequently identified medical conditions at death included bronchopneumonia , diarrhoea and failure to thrive . In multivariate analysis , prematurity ( RR=10.5 , 95%CI 3.8 - 29.1 , p<0.001 ) , teenage motherhood ( RR=3.6 , Cl 1.0 - 13.2 , p=0.05 ) and symptomatic maternal HIV-1 disease ( RR=2.7 , CI 0.9 - 7.7 , p=0.06 ) were associated with infant mortality . CONCLUSION Prematurity , teenage motherhood and symptomatic HIV-1 maternal disease were important predictors for post-neonatal mortality in this cohort of HIV-1 exposed uninfected infants . These factors should be considered in monitoring and follow up in prevention of mother-to-child HIV-1 transmission ( PMTCT ) programs BACKGROUND HIV contributes substantially to child mortality , but factors underlying these deaths are inadequately described . With individual data from seven r and omised mother-to-child transmission ( MTCT ) intervention trials , we estimate mortality in African children born to HIV-infected mothers and analyse selected risk factors . METHODS Early HIV infection was defined as a positive HIV-PCR test before 4 weeks of age ; and late infection by a negative PCR test at or after 4 weeks of age , followed by a positive test . Mortality rate was expressed per 1000 child-years . We investigated the effect of maternal health , infant HIV infection , feeding practice s , and age at acquisition of infection on mortality assessed with Cox proportional hazards models , and allowed for r and om effects for trials grouped geographically . FINDINGS 378 ( 11 % ) of 3468 children  died . By age 1 year , an estimated 35.2 % infected and 4.9 % uninfected children will have died ; by 2 years of age , 52.5 % and 7.6 % will have died , respectively . Mortality varied by geographical region , and was associated with maternal death ( adjusted odds ratio 2.27 , 95 % CI 1.62 - 3.19 ) , CD4 + cell counts < 200 per microL ( 1.91 , 1.39 - 2.62 ) , and infant HIV infection ( 8.16 , 6.43 - 10.33 ) . Mortality was not associated with either ever breastfeeding and never breastfeeding in either infected or uninfected children . In infected children , mortality was significantly lower for those with late infection than those with early infection ( 0.52 , 0.39 - 0.70 ) . This effect was also seen in analyses of survival from the age at infection ( 0.74 , 0.55 - 0.99 ) . INTERPRETATION These findings highlight the necessity for timely antiretroviral care , for support for HIV-infected women and children in developing countries , and for assessment of prophylactic programmes to prevent MTCT , including child mortality and infection averted OBJECTIVE To examine the relationships between  maternal knowledge and concern about HIV status , adoption of preventive practice s and risk of acquiring HIV in Zimbabwe . METHODS Knowledge and behavioural data were collected via interview from 2595 mothers enrolled in ZVITAMBO , a r and omized trial of postpartum vitamin A supplementation  that also offered education on safer infant feeding and sexual practice s. Mothers were tested for HIV at delivery ; those uninfected at baseline were retested during study follow-up . Logistic regression methods were used to identify variables associated with adoption of preventive behaviours and , for HIV-negative mothers , their relationship to risk of acquiring HIV post-delivery . RESULTS A total of 518 mothers ( 20 % ) reported practicing safer sex and 289 mothers ( 11 % ) reported modifying their feeding behaviour because of HIV . Fear of transmitting HIV ( 50.4 % ) and protecting the baby 's health ( 30.9 % ) were the most frequently cited reasons for behaviour change . Forty-nine HIV-negative mothers acquired HIV during the first postpartum year . After taking into account other significant covariates , mothers who were concerned about their own HIV status were 1.9 times more likely ( 95 % CI : 1.05 - 3.52 ; P = 0.03 ) , and those reporting safer sex practice s were 58 % less likely to become infected ( adjusted odds ratio : 0.42 ; 95 % CI : 0.17 - 1.04 ; P = 0.06 ) . Married women who reported practicing abstinence to prevent HIV were 3.2 times more likely to become infected than non-abstaining mothers ( P = 0.01 ) , while there were no new HIV infections among abstaining single mothers . CONCLUSIONS Greater emphasis should be given to safer sex practice s among women who test negative in mother-to-child HIV prevention programmes BACKGROUND The treatment of HIV infection during pregnancy significantly and substantially reduces the risk of mother-to-child transmission . Although triple therapy is the st and ard of care for management of HIV infection in adults , the safety of many approved antiretroviral agents in pregnancy is not currently established . METHODOLOGY An open-label pilot study conducted in Thail and and the UK of the safety of saquinavir soft-gel capsules 1200 mg three times daily administered in the second and third trimester of pregnancy in combination with local st and ard-of-care antiretroviral therapy . Infants received local st and ard-of-care antiretroviral therapy after delivery . Steady-state pharmacokinetics were performed in a subset of mothers at 4 weeks after the commencement of saquinavir therapy and paired sample s collected from the mother and infant cord blood at delivery . RESULTS Eighteen antiretroviral-naive pregnant 
    Output:
    
They offer evidence of beneficial synergies between PMTCT programs and both STI prevention and early childhood immunization .
En conjunto , este material ofrece evidencia de sinergias beneficiosas entre los programas de PTMI , la prevención de ITS y la inmunización en la infancia temprana .
Otros datos , incluyendo información sobre el cuidado prenatal y parto , planificación familiar y suplementacion de la nutrición varian considerablemente entre los estudios que demuestran un impacto positivo y negativo de la PTMI .