Only 30 babies out of 1,665 births from HIV-positive mothers tested positive for infection in last 5 years: MDACS

A 26-year-old woman from Chembur contracted HIV from her infected husband in 2017. After undergoing ART treatment for two years without developing any health complications, the couple decided to have a child. In February 2020, they welcomed their daughter, who tested negative for the infection.

“My daughter underwent the last DNA test in August and it came back negative for the infection. It was the happiest day of our lives. After contracting the infection, I never thought we would be able to be a mother,” the woman told The Indian Express.

Data from Mumbai District AIDS Control Society (MDACS) showed that per 56 deliveries of HIV infected mothers, only one newborn got the infection.

The HIV infection can pass to the child from infected mothers during pregnancy, labour, delivery or breastfeeding. In 2004, the National AIDS Control Organisation (NACO) introduced a combination of three drugs under antiretroviral treatment (ART), which were more effective in decreasing mother-to-child transmission rate than earlier drugs.

“Through ART, it is possible to reduce HIV to such a small quantity that it can no longer be detected by standard blood tests. It is called an undetectable viral load. A pregnant woman with undetectable viral load cannot pass on the infection to her baby,” said Dr Ishwar Gilada, president of AIDS Society of India (ASI).

But due to restrictions on the inclusion of pregnant mothers under ART treatment, the transmission rate remained at over nearly 10 per cent. It was only in 2015 when the ART treatment was made universal for all pregnant mothers irrespective of their CD4 count that the transmission rate started dropping.

“We start ART for all women as soon as their pregnancy is identified, which helps keep their viral load under control. Earlier, we were able to provide them treatment only if their CD4 count was of a certain level. Due to this change, the transmission rate in the womb and breastfeeding decreased,” said Dr Srikala Acharya, additional project director, MDACS .

In 2017, NACO made ART compulsory for all HIV patients without dependency on their CD4 count. “This further helped in providing treatment at an early stage of the infection and make the viral load undetectable,” she added.

All the mothers irrespective of their viral load count exclusively breastfeed their babies for six months as the milk contains antibodies and protein, which helps protect against other diseases like diaorrhea.“The expected mother-to-child HIV transmission rate in breastfed babies is 4 per cent. In Mumbai, it has been reduced to 1.8 per cent,” said Dr Srikala Acharya, additional project director, MDACS .

Any child who has been exposed to HIV in the womb is given syrup nevirapine, which helps to contain any possible chance of HIV infection from breastfeeding. “If a mother’s viral load is suppressed, then we give nevirapine to the newborn till six weeks after birth. If it is not suppressed then we give dual prophylactic, where along with nevirapine, we also give zidovudine, which is another group of antiretroviral infection to the baby till 12 weeks,” she said.

All newborns of infected mothers undergo DNA tests till they turn 18 months of age. The tests are conducted at the early infant diagnosis lab at Kasturba Infectious Diseases Hospital. The children are tested for DNA PCR three times — at six weeks, 12 months and 18 months.

Babies who are born with HIV infection can also have a normal life with proper adherence to the ART regime. “We have 174 patients who have been on ART since 2004 when the programme was first launched,” said Dr Acharya.