Prevention of mother to child transmission of hiv infection
Mother-to-child transmission is the most common source of HIV infection among children. About one million people are estimated to be living with HIV infection all over the world.
Majority of these children are from the developing countries, especially Africa. Since HIV/AIDS is spreading rapidly in India, the number of pregnant women with HIV infection is also increasing.
As a result the number of children who get HIV infection through their mothers is also increasing.
Until recently, two main strategies were adopted to prevent mother-to-child transmission of HIV infection.
These included: Preventing women in the childbearing age from becoming infected and secondly to promote family planning services in order to prevent unwanted births.
Although these two strategies continue to remain the most important strategies for preventing mother-to-child transmission, a third option is being explored for reducing this mode of transmission.
This is to give medicines that slow down the multiplication of HIV to pregnant women and sometimes to the infant too.
In developed countries, breast feeding is normally not recommended for babies born to mothers with HIV infection.
However, the risk of ill health and death for a baby in countries such as India due to poor nutrition and diseases such as diarrhea is much greater than the risk of getting HIV infection through breast feeding.
This is why all women in India, irrespective of whether they have HIV infection or not, are advised to breast-feed their babies.
One study in Thailand has indicated that taking a short term treatment of zidovudine greatly reduces the risk of mother-to-child transmission. The risk is reduced to below ten percent if breast feeding is strictly avoided.
However in countries such as India where breast feeding is important for prevention of infections such as diarrhea for the infants, breast feeding is recommended for all women, even if they have HIV infection.
Some studies are underway to test whether a group of medicines are more effective than zidovudine. Initial reports of a study using zidovudine and lamivudine has shown promising results.
More studies are underway to determine alternative medicines or groups of medicine that may further reduce the risk of mother-to-child transmission.
Some factors may increase the risk of mother-to-child transmission of HIV infection.
The risk of transmission is estimated to be two times higher in a mother who has been recently infected with HIV as compared with a women who had earlier infection.
Vitamin A deficiency is also associated with increased risk of mother-to-child transmission.
It is also suspected that fissures in the nipples of the mothers and oral thrush or wounds in the mouth of the babies increase the risk of mother-to-child transmission.
This is because they allow the virus to enter the blood more easily.
It to be understood that the strategy of prevention of mother to child transmission of hiv infection, will go a long way in reducing HIV / AIDS globally.