Infant AIDS Could Be Cut
January 2, 2004
A CDC study at Atlanta's Grady Memorial Hospital found that some pregnant women infected with HIV are still passing the disease onto their babies. Of 131 HIV-positive women, nine delivered infants with the virus in 1999-2000, the study showed.Adapted from:
Mother-to-child HIV transmission rates have decreased greatly due to antiretroviral drugs women can take without harming the fetus. But it will take more intervention to reach low-income pregnant women who lack prenatal care and those who are addicted to drugs, CDC researchers said.
"We know that if we can get women into prenatal care, get them properly tested and start them early on antiretrovirals, we can reduce the transmission rate to about 2 percent," said Dr. Mary Glenn Fowler, who oversees CDC's perinatal HIV research. "This study shows the failures, those who slipped through, and the numbers are reflective of what we see nationally."
Ten years ago, before the introduction of antiretrovirals, about 25 percent of infants born to infected mothers were HIV-positive, Fowler said. That figure is now about 5 percent, she noted.
No cases of mother-to-child HIV transmission were identified among Grady's pregnant clients who fully participated in the hospital's three-pronged program: prenatal counseling, HIV testing, and proper adherence to the antiretroviral drug regimen. In at least four of the HIV-positive infants, the study showed, taking the full regimen of antiretroviral drugs could have prevented transmission of the virus. Six of the nine mothers delivering infected infants received no prenatal care.
In 1995, the U.S. Public Health Service recommended all pregnant women receive HIV counseling and be offered voluntary testing. That strategy, combined with scheduled Caesarian section deliveries, should reduce transmission rates, the study said. Residential treatment plans for homeless or drug-addicted pregnant women could also reduce transmission rates.
All infants born to HIV-positive mothers get AZT for six weeks as a precaution. Infants who contracted the virus in utero stay on antiretrovirals for life. The study, "Prenatal HIV Testing and Antiretroviral Prophylaxis at an Urban Hospital -- Atlanta, Georgia, 1997-2000," appeared in Morbidity and Mortality Weekly Report (2004; 52(51):1245-1248).
01.02.04; Patricia Guthrie
This article was provided by CDC National Prevention Information Network. It is a part of the publication CDC HIV/Hepatitis/STD/TB Prevention News Update.