By Sally Robertson, BSc
A pregnant woman that is HIV-positive can easily pass the virus onto her baby throughout pregnancy, throughout childbirth or through breastfeeding. This mother-to-kid transmission, likewise referred to as perinatal transmission, is the the majority of common route of HIV infection among children.
When a woman is diagnosed along with HIV throughout pregnancy, treatment along with a combination of antiretroviral medications can easily reduce the risk of this transmission to much less compared to 1%.
Treatment is the majority of efficient if started as early on as feasible throughout the pregnancy, even though start treatment at a later stage or even throughout delivery can easily be greatly beneficial.
Medication
HIV medications are used at the complying with times:
- During pregnancy HIV-positive women receive antiretroviral therapy (ART) which involves a combination of a minimum of three drugs
- During labor and delivery, oral medications are continued and she is likewise administered intravenous zidovudine (likewise called AZT)
- After birth, babies are administered AZT for 6 weeks. Along with AZT, babies born to mothers that did not receive HIV drugs throughout pregnancy might likewise be provided various other HIV drugs.
HIV medications job by cutting down the quantity of HIV (viral load) present in the mother’s body, ideally to an undetectable level.
This reduces the opportunity of the mother passing the virus on to her baby throughout pregnancy or birth. A few of these drugs can easily likewise cross the placenta and reach the physique of the unborn baby, which can easily insight to protect it from infection.
This is pretty essential throughout delivery Once the baby is at risk of exposure to any type of virus present in the mother’s blood or various other physical fluids.
Medication Risks
When advising on HIV drug routines for usage throughout pregnancy, healthcare providers think about the rewards and risks of the various medications available including the short- and lasting effects on babies born to HIV-positive mothers.
Although research has actually not revealed any type of clear association between the usage of these medicines and birth defects, some drugs have actually raised concerns.
In the US, women taking these drugs throughout their pregnancy are advised to enrol in the Antiretroviral Pregnancy Registry, which monitors prenatal exposure to these medications in order to identify any type of potential increased risk of birth defects related to their use.
Breastfeeding
HIV is present in breast milk. However, advances in the usage of ART have actually meant that HIV-positive women no longer should stay away from breastfeeding.
In 2011, the British HIV Association updated their Placement Paper to state that if an HIV-positive mother has actually already been receiving triple ART and was repeatedly revealed to have actually an undetectable viral load throughout delivery, after that she may, after thorough consideration, proceed along with breastfeeding throughout the very first 6 month’s of the child’s life.
However, if she does go for this option, she must breastfeed exclusively due to the fact that mixing the dairy products along with various other meals enhances the risk of HIV being passed onto the baby.
The guidelines for HIV-positive mothers that go for to breastfeed recommend the following:
Mothers must receive:
-
Support in their decision to breastfeed exclusively
-
Triple ART for much more compared to 13 weeks prior to delivery and likewise until one week after weaning
-
Monitoring to make certain an undetectable viral load (of much less compared to 50 copies per mm3)
-
Follow-up checks on a normal basis to inspect medication adherence
-
Rapid treatment of any type of complications that arise along with breasts or breastfeeding
Infants must receive:
Reviewed by Susha Cheriyedath, MSc
