Prevention of Mother-to-Child Transmission

There's nothing like hearing the results of studies directly from those who actually conducted the research. In this summary, you'll hear Louise Kuhn, Ph.D., Associate Professor of Epidemiology in the Gertrude H. Sergievsky Center, College of Physicians and Surgeons at Columbia University, in the Mailman School of Public Health, summarize her plenary talk "Prevention of Mother-to-Child Transmission."¹ To view a video of the plenary session, click here. To view her slides, click here.

Louise Kuhn, Ph.D.

I spoke this morning on prevention of mother-to-child transmission. What I was trying to do was to make two points. The first point which I was trying to make was that it's very, very important that pregnant women and breastfeeding women who have CD4 counts less than 350 should receive HAART [highly active antiretroviral therapy] for their own health. This intervention will be beneficial to maternal health, and will reduce maternal mortality and improve the quality of lives of young mothers.

This intervention will also prevent mother-to-child transmission: transmission that happens during the pregnancy, and also transmission that happens during the breastfeeding. There are now several very clear studies showing the benefits of maternal HAART, and this is really an absolutely win-win intervention. It's very, very important. But it's not difficult in practice. So it's very important that programs get sufficient resources to implement this intervention, because it's probably the single most effective thing, both for transmission and, of course, for maternal health.

That was the first point which I was trying to make in my presentation. The second point I was trying to make is that prevention of mother-to-child transmission programs have to think about child survival, in general, and can't simply focus on HIV prevention. Because there's very little point of preventing HIV if we are simply causing other fatal diseases in these children. So we have to think about the promotion of child survival, in addition to thinking about prevention of HIV.

Again, the way in which to accomplish this is really through the first point, which is the provision of maternal HAART. Some of the attempts to look at providing formula and shortening the duration of breastfeeding have unfortunately been a failure. They have not improved child survival, and they have caused other diseases among children.

So it's important that we then go back to, rather, providing antiretroviral treatment to the mother so that we can reduce HIV transmission through breastfeeding.

This transcript has been lightly edited for clarity.

Reference

1. Kuhn L. Prevention of mother-to-child transmission. In: Program and abstracts of the 5th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention; July 19-22, 2009; Cape Town, South Africa. Abstract MOPL103.
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