Which statement is most accurate about a pregnant woman who is HIV positive and the risk to her fetus?

• A. Placental transmission is uncommon, and without intervention the overall risk to the child is about 5–10%.
• B. HIV can be transmitted before birth, during delivery, or through breastfeeding, and without treatment the risk is 15–45%, but proper antiretroviral therapy can reduce it below 2%.
• C. Most transmission occurs during delivery, and without treatment the combined risk including other routes is about 10–25%.
• D. Consistent maternal ART and formula feeding greatly reduce the risk, and transmission is often reported as effectively zero in many settings.

Answer: (B)