Thursday, Oct 23, 2014

Triple-drug regimen for HIV-positive pregnant women soon

Pune | Posted: October 4, 2013 1:13 am

For the first time,HIV positive pregnant women will be given a three-drug regimen to cut the risk of transmission of the virus to their newborns. The ambitious programme will soon be rolled out across the state.

A three-day programme was launched at Pimpri on Thursday where training on the drug regimen was imparted to district health officials,medical officers from government colleges and Anti-Retroviral Treatment (ART) centres.

Dr Asha Hegde,in-charge of the Prevention of Parent to Child Transmission (PPTCT) programme of Maharashtra State AIDS Control Society (MSACS) who is conducting the training,said the prevalence of HIV infection in pregnant women has come down from 3 per cent to 0.4 per cent.

As per the World Health Organisation’s (WHO) new guidelines on treatment for PMTCT (preventing mother-to-child transmission) and on HIV and breastfeeding,instead of a single drug,the HIV positive pregnant woman will be given a three-drug regimen that consists of drugs lamivudine,efavirenz and tenofovir,said Dr R A Bhosale,Head of the Department of Obstetrics and Gynaecology,B J Medical College. Hegde,who is supervising the training,said the triple-drug regimen should be taken throughout pregnancy,delivery and breastfeeding,continuing for life,regardless of CD4 count or clinical stage.

Presently there are an estimated 4.5 lakh people living with HIV in the state,of which 1.3 lakh people are on anti-retroviral treatment provided free of cost at 72 ART centres. There are an estimated 20,000 children living with HIV in the state,of which 6,000 are on ART. Since 2010 till now a total of 1,000 babies were detected with HIV under the Early Infant Diagnosis (EID) programme,Hegde said.

Till now,an HIV positive pregnant woman was given a single drug therapy (Nevirapine) to prevent the infection to the

foetus. Despite administering this drug to the mother during labour and the child after birth,the newborn has an 8-10 per cent chance of infection. With the new drug regime,the chances of infection could go down to 1-2 per cent,programme experts said.

In Pune,every year approximately 10,000 pregnant women are enrolled at Sassoon General Hospital. Bhosale said since the government hospital gets referrals from other places,the HIV positivity rate in pregnant women varies from 2-2.5 per cent. While NVP has been effective,research has shown that there is resistance to this drug and hence the triple drug therapy has been recommended,he said.

ANURADHA MASCARENHAS

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