California: Program Helps Pregnant Mothers Infected With HIV

Alameda County's Family Care Network and the University of California-San Francisco Medical Center have started a 24-hour pager consultative service to advise hospital workers in treating HIV-infected pregnant women.

Officials have distributed a toll-free number to more than 100 delivery units and emergency rooms throughout northern California. The focus is weekends, holidays and nights, when one of 10 clinicians with experience treating HIV-infected pregnant women will be available. "Unless you're doing this all the time, [the technology] is impossible to keep up with. Patients have a right to know what is cutting-edge," said Stephanie Mann, a perinatologist at the UCSF Medical Center and one of the program's experts.

Beth Hennessy, manager of perinatal services at Sequoia Hospital in Redwood City, said she recently instructed her staff on how to use the service. Sequoia delivers 1,300 babies a year but rarely deals with drop-in, HIV-infected patients, Hennessy said. "It would be helpful to have the information a phone call away," she said. "We might be talking about one case a year."

Mann said treating an HIV-infected woman involves many variables, from the dosage of AZT and other drugs to making decisions about breast-feeding. Treatment can also change for premature babies, and HIV infection can affect delivery methods.

Without therapy, babies born to HIV-infected mothers face a more than 25 percent chance of contracting the virus, Mann said. In the early 1990s, 1,000 to 2,000 infants per year were born HIV-positive in the United States, according to CDC. But in 1994, a landmark study showed the efficacy of AZT in preventing transmission. In 2000, 280-370 infants were born with HIV, and the risk of transmission now may be as low as 1 percent with proper care, CDC said.

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