Kunti Devi, a 39-year-old HIV positive patient, put her to-be-born child at risk of acquiring the virus as she was devoid of any treatment. Her child is not the only one to be a victim of mother-to child transmission, as experts point out that nearly 45 percent children borne by HIV-infected mothers are susceptible to the virus in the absence of any interventions.
R.K Sharma, director and head of department, institute of reproductive medicine and IVF Centre, Primus Super Speciality Hospital, said that HIV can be transmitted both "horizontally (from one partner to another) and vertically (from mother to child)".
He, however, added that if identified early and correct preventive measures are immediately taken, such transmissions can be averted.
"There are set protocols for preventing transmissions from mother to child. Thus, following these norms and standards under medical ethics and guidance can definitely stop mother-to-child transmission. The general public and particularly, HIV patients, must be well-informed about the relevant information in this context. The HIV load in society can be decreased by disseminating proper counselling and management," Sharma told IANS.
According to the World Health Organisation, the transmission of HIV from an HIV-positive mother to her child during pregnancy, labour, delivery or breastfeeding is called mother-to-child transmission. In the absence of any interventions, transmission rates range from 15-45 percent.
According to National AIDS Control Organisation estimates, 21,000 children are born infected every year through mother-to-child transmission in India.
It is estimated that around 116,000 new HIV infections among adults and around 14,500 new infections among children occurred during 2011.
Also, children below 15 account for seven percent of all infections, while 86 percent are in the 15-49 age group. Of all HIV infections, 39 percent are among women.
Satish Koul of the internal medicine department at Gurgaon's Columbia Asia Hospital said that while in the absence of any interventions, transmission rates range from 15 to 45 percent, these can be reduced to below five percent with effective interventions.
"The risk of mother-to-child transmission of HIV is low when women with HIV receive medicine during pregnancy and childbirth and, in certain situations, have a scheduled cesarean delivery. Also, babies born to women with HIV receive HIV medicines for six weeks after birth and are not breastfed," Koul told IANS.
Madhu Ahuja, obstetrician and gynecologist, Max Super Speciality Hospital,Patparganj, said that apart from a cesarean delivery and avoiding breastfeeding, it is essential for the mother to receive anti-retroviral drugs during pregnancy, labour, and delivery; and also for the baby to receive treatment for protection.
She added that while the percentage of transmission ranges between 20 and 45 percent for breastfeeding mothers, for the non-breastfeeding ones it ranges between 15 and 30 percent.
"The risk of infection is less than two percent if the mothers take anti-retroviral drugs and if they follow a protocol where they opt for a cesarean delivery and formula feed the baby," Ahuja told IANS.
Standard anti-retroviral therapy (ART) consists of the combination of at least three anti-retroviral (ARV) drugs to maximally suppress the HIV virus and stop the progression of HIV.
So, is there a need to raise awareness regarding pre-natal diagnostics?
"Yes there is a definite need of raising awareness without any bias or prejudice. As of now, not only rural but even urban people do not feel comfortable asking openly for screening tests for HIV. Effective screening is required. However, this should not result in social isolation or discrimination of HIV positive people," Alka Sinha, senior consultant, gynecologist and laparoscopic surgeon, BLK Super Speciality Hospital, told IANS.
She further highlighted the involvement of the community and the need for both the public and the private sector to come forward together to help minimize the risk of mother-to-child transmission.
"We have to begin right from school, where teenagers should be given appropriate information about HIV and sexual and reproductive knowledge. Emphasis has to be placed on safe sexual practices and the detrimental effect of drugs. Healthcare centres have to raise the bar and ensure that inadvertent transmission of HIV infection is checked," she said.
(Shweta Sharma can be contacted on firstname.lastname@example.org)
--Indo-Asian News Service shw/kbd/vm
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