Written By: Bhavyajyoti Chilukoti | Updated : November 29, 2017 1:01 PM IST
World AIDS Day is on December 1st
HIV/AIDS is a deadly disease. Although there are many ways of HIV transmission, the most talked about and preventable one is mother to child transmission of HIV. With latest advances in the treatment of HIV it is possible to deliver a healthy child even if you are HIV positive. But still, people have many queries- can HIV be transmitted even if you are on medications? Can mother to child transmission of HIV be prevented? Our expert Dr Raj Hajrani*, Dermatologist and HIV specialist, Aashirwad Hospital, Mumbai answers some of the common queries related to the mother to child transmission of HIV.
1. Can mother to child transmission (MTCT) be prevented?
Yes, mother to child transmission can be prevented even if you are not sure about your HIV status. All you need to do is talk to your gynaecologist about the options that are there to prevent the risk of HIV transmission to the infant. Here's everything you need to know about HIV/AIDS.
2. How to prevent mother to child transmission?
If you are pregnant and don't know about your HIV status, you might be recommended anti-retroviral therapy. Depending upon the cost and the severity of the infection, you are advised to be on medications before delivery. Even after delivery, you are supposed to take medications. Breastfeeding is recommended under expert supervision depending upon the viral load. However, if it is a planned pregnancy, then medications are prescribed right from your diagnosis of HIV to lower the risk of transmission of the infection to the growing fetus. Also, care is taken that drugs for HIV do not cause any side-effects to the foetus.
3. Can a woman with HIV breastfeed?
It depends on the socio-economic status of the person, because as a rule, WHO recommends that the mother can avoid breastfeeding if she can afford replacement feeding or if the other alternatives of breast milk are safer. Hence, if a woman is from lower economic strata, she has to breastfeed as lack of financial support to opt for formula feeds and poor hygiene and sanitation might lead to severe diarrhoea in the infant, which can even cause death. A woman from higher socio-economic strata, who can afford formula feeds is advised to avoid breastfeeding and opt for formula feeds.
4. Is HIV testing recommended during pregnancy?
Yes, it is very important, and one should undergo HIV testing during every trimester to rule out HIV/AIDS. In fact, prenatal checkups recommended during the first trimester include testing of HIV and other infections. Also, both the partners (husband and wife) should go for clinical tests in the first, second and third trimester of pregnancy as there is always a risk of any recent infection and high viral load, which might increase the possibility of transmission in the kid. Here is more on HIV diagnosis 5 tests to detect a recent HIV infection.
5. What makes pregnant women more likely to transmit HIV to her baby?
The is a high risk of transmission of the HIV during pregnancy if you have a high viral load (which is usually seen in people with a recent infection or thoe who are not taking medications) and maternal malnutrition to name a few. There have also been cases where the mother was HIV negative, but the father was HIV positive, which is a challenge for doctors. However, with ART, the risk of transmission can be controlled, and the patients can conceive a healthy baby without any infection, explains Dr Raj Hajrani.
6. Can HIV medicines prevent MTCT of HIV?
Yes, it has been proved that all antiretroviral therapies have a full control on preventing the risk of transmission of HIV. However, the rate of transmission depends on the viral load. If the viral load is undefinable, then the chances of transmission is 0%. Read more on is there a cure for HIV/Aids and latest advances in HIV treatment in India.
7. Are these medicines safe during pregnancy?
Most of the drugs for HIV/AIDS are safe to prevent transmission to the growing infant. However, just like any other medications, even these medications have side-effects which account for only 2%. When compared to the benefits of the drugs in preventing the transmission, the side-effects are comparatively less and most people tend to accept and live with the side-effects.
8. If a pregnant woman has untreated HIV, what is the probability that she will transmit it to her baby?
There is a 32% risk, which means that for every 100 undetected cases of HIV, 32 pregnant women might transmit the HIV infection to her baby. And this is the reason it is recommended to undergo HIV screening and tests even during the third trimester of pregnancy. Read about 12 HIV/AIDS symptoms that you need to watch out for.
9. Can someone under ARVs prescription transmit HIV?
In most cases, ARVs (antiretrovirals) are extremely effective in lowering the viral load. However, there are cases in which the patients might be resistant to the medications and the viral load is not suppressed, which increases the chances of transmitting the infection to an infant. In such a case, the expert might recommend changing the medications with high concentration to lower the intensity of the viral load to undefinable (o%, in which case the chances are relatively low)
10. What would be the best approach to stop HIV/ AIDS in infants?
The approach to stop HIV/AIDS in infants is to take medications as prescribed by the doctor without fail. In addition to this, there are three key approaches - (1) Prenatal intervention - when pregnant, undergo the test and if positive, start taking medications. (2) Undergo C-section -- This is because delivery through C-section lowers the infant's exposure to the mother's bodily fluids. (3) Postpartum care: It is highly recommended that the mother and the child should undergo post-exposure prophylaxis which acts as a preventive approach to stop HIV transmission (if there's even a slight risk of infection). Howver, the mother, has to take drugs throughout her life to lower the risk of progression of HIV into full-blown AIDS. Also read about 33 Frequently Asked Questions (FAQs) about HIV.
(*Dr Raj Hajrani specialises in Skin and Sexually transmitted diseases (STDs). He has a clinic in Thane and also specialises treating infertility and pregnancy in HIV positive people.)
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