Mother-to-child HIV transmission on decline in US, but more can be done

With the advent of new therapies, HIV transmission to kids before or at birth has declined dramatically in the US in the last decade, but scientists believe there is still scope to do more and further reduce the number of babies born with the disease.

 

Paediatric HIV experts at the University of Florida said that In US, the decreasing number of paediatric infections is a direct result of the advent of powerful anti-HIV therapies in the mid-1990s and the establishment of protocols by the Centers for Disease Control and Prevention to treat pregnant women who are infected, and their babies.

 

Increased HIV-testing outreach and education efforts have also paid off. And CDC guidelines for "opt-out" HIV-testing for pregnant women mean testing is a routine part of their care, and women would have to specifically decline it.

 

Rapid testing during labour and delivery gives one last chance to administer therapies that can prevent transmission.

 

"This is one of those diseases for which we learned how to prevent transmission. We need to make full use of this method and our energies need to be focused on the effort," said lead researcher Dr Mobeen Rathore.

 

"The reduction of mother-to-child HIV transmission is one of the biggest success stories of the HIV epidemic. The question is, 'How low can we go?'" said Thomas Liberti, chief of the bureau of HIV/AIDS in the Florida department of health.

 

Researchers reviewed pediatric HIV data for the period from 2002-09, and found 102 cases.

 

Despite the many effective measures in place to help prevent HIV-transmission to babies, there are missed opportunities, found the researchers.

 

Mothers of half of the infected babies tested positive for HIV before becoming pregnant.

 

But some refused or neglected to take the medications that could have kept their babies HIV-free.

 

Some had no prenatal care, and so did not receive available treatments.

 

Some women were HIV-negative at the start of their pregnancy, but became infected afterward.

 

Others were diagnosed with HIV only after the birth of their babies.

 

Repeat testing during pregnancy and rapid testing during labour and delivery would have alerted health care providers.

 

Finding creative ways to address issues such as the shortage of mental health-care providers will help women and their babies get needed care, the researchers said.

 

The health department has already begun discussions with the Centers for Disease Control and Prevention to discuss steps that can be taken to further reduce mother to child HIV transmission.

 

"Many of our patients have mental health and other life issues, so if we do not address them, the treatment protocol will not be effective. This is an intervention that has the opportunity to work better," said Rathore.

 

The study was presented during the 18th International AIDS conference in Vienna, Austria.