By Ed Susman
MEXICO CITY -- August 5, 2008 -- The use of antiretroviral therapy during pregnancy among women infected with human immunodeficiency virus (HIV) reduces the transmission rate to newborns to less than 1%, according to study findings presented here at the 17th International AIDS Conference (AIDS 2008).
In a prospective treatment review presented here at a poster session on August 4, John C. Forbes, MD, Oak Tree Clinic, University of British Columbia, Vancouver, British Columbia, described outcomes among 1,980 babies delivered by HIV-infected Canadian women since 1990. The mothers of 1,066 of those children were treated with highly active antiretroviral therapy (HAART), and the rate of transmission of HIV was 1.2%. If the women received only some antiretroviral therapy, the transmission rate was 3.4%; if the mothers received no antiretroviral therapy, the transmission rate was 21.4%.
"The decline in Canada's HIV vertical transmission rate shows the success of Canadian prenatal, perinatal, and postnatal HIV prevention programs," Dr. Forbes said, speaking on behalf of his colleagues in the Canadian Pediatric AIDS Research Group. "A few HIV-infected children are still born in Canada each year. This highlights a need to further optimise our prevention strategies by improving access to women in injecting-drug use, aboriginal, and immigrant populations."
The success of the HIV prevention program was illustrated by 2007 statistics. A total of 161 babies were born to women who received HAART during pregnancy. None of those babies was HIV infected. An additional 8 children were born to mothers who received some antiretroviral therapy. None of those children was HIV infected. Of the 26 children who were born to mothers who did not receive any prenatal antiretroviral therapy, only 1 child (3.8%) was born HIV infected, Dr. Forbes said.
"Renewed efforts should be made to avoid 'missed opportunities' of prevention," Dr. Forbes concluded. Among those efforts are included universal implementation of HIV testing in pregnancy; improved access to prenatal care among marginalised groups such as addicted persons; testing partners of patients; and retesting for HIV during the third trimester of pregnancy.
[Presentation title: Perinatal HIV Transmission and Demographics in Canada: Data From the Canadian Perinatal HIV Surveillance Program (CPHSP) Since 1990. Abstract MOPE0215]
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