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is Mother to child trasmission possible even under ARV?

May 31, 2012

My HIV + wife was under ARVs while preg. The delivery was by ceserian section. Continued taking the ARVs together with the child while breastfeeding. After 7 days the breastfeeding was stopped due to insufficient milk from the mother.ARVs were stopped 3days later after starting artificial milk.

Two months later the child started to develop recurence hihg fever, chest tightness and dry coughing.

Now 4months the baby boy is hospitalized from very serious above condition. HIV test shows + reaction

Is crosstramission possible even when the mother started taking ARVs while 3months preg? Though under antibiotics will the child survive? What is your advise to the life of the child?

Response from Dr. Wohl

It is important to understand what test was used to determine the HIV status of the child. HIV antibodies from a mother can be found in newborn blood for months and does not reflect infection. These antibodies eventually disappear, typically by a year after birth.

So, if an antibody test was done, it may not indicate the child is HIV infected. A special test called a PCR or viral load is used in the US and Europe to look for the actual virus. If that is positive, then there is true infection. If no viral load test is available then repeat testing for HIV antibodies is recommended out to a year. If it remains positive, then infection is diagnosed.

Meanwhile, as the child is ill, it is best to assume that the baby is HIV+ and treat accordingly.

IF the child is truly infected this could have been during breastfeeding despite ARVs. Also, while ARVS before, during and after birth reduce the risk of transmission significantly, it is not absolute and some transmission remains possible.

Hopefully, your doctors are knowledgable and can determine if HIV is really present and how to best treat regardless of HIV status. Good luck. DW

undetected viral load
Shingles vaccine recommendation?

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