Mother to Child transmission of HIV

MOTHER TO CHILD TRANSMISSION OF HIV/AIDS
The transmission of HIV from a HIV-positive
mother to her child during pregnancy, labour,
delivery or breastfeeding is called mother-to-child
transmission. In the absence of any intervention,
transmission rates range from 15% to 45%. This
rate can be reduced to below 5% with effective
interventions during the periods of pregnancy,
labour, delivery and breastfeeding.
HIV can pass from an HIV-positive mother to her
child:
During pregnancy – the foetus is infected
by HIV crossing the placenta.
During childbirth – the baby is infected by
HIV in the mother's cervical secretions or
blood.
During breastfeeding – the baby is
infected by HIV in the mother's breast
milk (or blood).
Because of this, efforts to prevent HIV
transmission need to incorporate strategies which
cover the entire period from pregnancy to infant
feeding.
PREVENTIVE MEASURES
Prevention of mother-to-child transmission
(PMTCT) programmes provide antiretroviral
treatment (ART) to HIV-positive pregnant
women to stop their infants from acquiring the
virus.
Without treatment, the likelihood of HIV passing
from mother-to-child is 15% to 45%. However,
ART and other effective PMTCT interventions
can reduce this risk to below 5%.
Around 1.6 million new HIV infections among
children have been prevented since 1995 due to
the implementation of PMTCT services. Of
these, 1.3 million are estimated to have been
averted in the five years, between 2010 and
2015.
Despite this significant progress, in 2015 23% of
pregnant women living with HIV did not have
access to ARVs and 150,000 children (400
children a day) became infected with HIV.
An HIV-positive mother can pass HIV on to her
baby any time during pregnancy, labor, delivery
and breastfeeding, so the transmission of the
virus must be blocked at each stage. The 2010
World Health Organization guidelines
recommend that HIV-positive pregnant
mothers should go on a regimen of three
antiretroviral drugs (ARVs) as soon as possible
— and stay on these drugs until their infant is
born and breastfeeding has concluded.
As soon as the infant is born, the baby should
take nevirapine — a very inexpensive drug —
daily for six weeks. The infant should be
formula-fed rather than breastfed if possible,
but it’s recognized that formula feeding is both
expensive and difficult to do safely in
resource-limited settings, so the mother is
recommended to breastfeed her child
exclusively for six months while continuing to
take ARVs. In a recent study conducted by
Harvard University in Botswana, mothers who
adhered to this regimen reduced transmission
of HIV to their babies by an amazing 99
percent.
These prevention guidelines have evolved over
the years as scientists have learned more
about how to most effectively reduce the risk
of transmission while also working to minimize
drug resistance for our most effective
treatment tools. Many policymakers stress that
access to effective contraception to prevent
unintended pregnancies is also important for
women who are HIV-positive.

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