HIV Transmission:
Mother to Child

If a mother has HIV does it mean her baby will also become infected with HIV? This question takes on special meaning for many women living with HIV today. Many women still are not aware that they are HIV-positive until they get tested during pregnancy, while some women choose to start families after they know about their HIV status. So what’s to low down are both of these groups of women going to give birth to babies infected with HIV? Studies have shown that women who receive no drugs to fight HIV give birth to HIV infected babies about 33% of the time. Several studies show that the number can be decreased to around 8% if the mother takes AZT during her pregnancy and the Baby takes AZT for six weeks after birth.

With the new combination of anti-HIV drugs available can that number decrease anymore? A couple of new studies suggest that the risk to children born to HIV-positive women can be reduced if the mother is receiving combination therapy that lowers their viral loads.

What are the things to consider for the Mother?

Early studies that show the effectiveness of AZT therapy in the prevention of mother to child transmission of HIV failed to address the issue of how a single drug therapy with AZT would effective the health and long term survival of the mother. Public Health Service Guidelines recommend that a combination therapy including at least three anti-HIV drugs should be offered to any one who has a viral load above 10,000 copies, including HIV-positive pregnant women.

Two recently published studies seem to suggest that if mothers are on combination therapy that drops their viral load down to very low levels, the chance of infecting the newborn child is greatly reduced. It is important to remember that a high viral load for the mother does not guarantee the baby will become HIV-positive but it probably increases the risk to the child.

These studies also suggest that beginning successful therapy at any stage of the pregnancy will decrease the risk of infection for the child. If you find out your HIV-positive during your pregnancy you should still discuss aggressive anti-HIV drugs with your Doctor. In fact a study conducted in Africa showed that women who took no anti-HIV drugs other than one dose of the drug Viramune during labor transmitted HIV to their children only 13% of the time (the babies also took one single dose of Viramune within tree days of birth).

We often times forget that a mothers long-term health is also crucial for the upbringing of the child. If a mother is offered therapy that does not improve her health it can effect her ability to meet all of the challenges mother face when raising and caring for their young children.

What about the long term effects for the baby?

This is a fairly hard question to answer because there is very little information available. Several of the studies mentioned above are planning to follow the health of the children born to mothers of the study. Because a number of these studies are preformed in countries with devastating levels of poverty and poor access to basic supplies needed to guarantee healthy development of any child it will be hard to determine if the anti-HIV drugs had any long term bad effects.

Mothers will have to make a decision on what course of action they choose based on limited information about its long term effect on both their children’s health and their own health. Before any pregnant women begins anti-HIV therapy they should discuss both the benefits and disadvantages of each drug regiment proposed with their Doctor. Working together with their doctor mothers can develop a plan their protects their own health while greatly reducing the risk of infecting their new born children

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