Mother to child HIV transmission can be stopped

• The mother to child transmission of HIV is referred to as “vertical transmission” and can occur during pregnancy, childbirth and through breast feeding.

• The risk of such a transmission in developing countries is reported to be between 30-50 per cent if the baby is breastfed for 18 months. The risk at other times is less—5-10 per cent during pregnancy and 10-15 per cent during delivery.

WHERE AND HOW

• A few simple measures can prevent transmission of HIV infection. These interventions are available at many government health facilities through the “Prevention of parent to child transmission of HIV Programme” being implemented by the NACO.

• In this programme, a pregnant women is offered an HIV test in an anti-natal clinic. If the test turns out positive, she is requested to come back for an institutional delivery. During delivery, she is administered a single tablet of an anti-retroviral drug Nevirapine.

• The newborn is also administered one dose of Nevirapine within 72 hours of birth. It is also ensured that interventions like episiotomy (widening of vaginal opening to facilitate delivery) and artificial rupture of membranes are avoided.

• The mother is also counselled on infant feeding options. If she can afford it, the baby is put on replacement feeds (other milks). Otherwise, breast feeding is continued for first six months, after which the baby is weaned and put on semi-solid feed.

THE 6TH W: WHAT NEXT

• Nevirapine is a safe and effective drug and reduces the risk of HIV transmission by about 50 per cent. Recently, however, there have been concerns about the development of resistance to it.

• As a result, NACO has been considering the introduction of a combination of ARV drugs (Zidovudine, Lamivudine) to HIV-infected women during pregnancy. These multi-drug regimens are said to be more effective in preventing transmission of HIV from mother to the baby.