Australia: Fed: Inadequate Testing for HIV Putting Babies at Risk

Despite evidence that screening can minimize the risk for mother-to-child transmission (MTCT) of HIV, only half of Australia's obstetricians routinely test pregnant women for the virus, according to a team of infectious disease specialists from the Royal Women's Hospital in Victoria. The group asked the majority of the nation's registered obstetricians about their handling of infectious diseases in pregnancy and found that 51 percent said they always offered HIV tests, compared with 60 percent for hepatitis C (HCV) and 97 percent for hepatitis B (HBV). "The Royal Australian and New Zealand College of Obstetricians and Gynecologists recommends that all women should be offered the test [for HIV]," noted study co-author Dr. Michelle Giles.

Those obstetricians who did not routinely offer HIV testing were likely to be basing their decision on the woman's risk factors for HIV, such as sexual and drug-use history and country of origin, according to Giles. "But in Australia the main risk factor for women with HIV is heterosexual contact with a partner who had HIV so if you only tested those who had used drugs or came from certain countries you might miss a number of women," she added.

One-third of the surveyed obstetricians said they would always offer an elective caesarian section -- which evidence shows can reduce MTCT -- to HIV-infection women. "With no treatment, no intervention or medicine, the rates of HIV transmission from mother to baby vary from 15 to 35 percent. But if the mum is on treatment, it's well controlled and she has a caesarian section and doesn't breast feed, the risk is less than 2 percent," said Giles.

Giles reported that screening tests for HBV and HCV were being offered to women at about the right frequency.

The study, "An Audit of Obstetricians' Management of Women Potentially Infected with Blood-Borne Viruses," was published in the Medical Journal of Australia (2004;180(7):328-332).

Back to other news for April 9, 2004