Review of prevention of mother –to – child transmission of HIV

Abstract

Background: The total number of AIDS death since the epidemic started is estimated at 21.8 million worldwide, of which 4.3 million were in children. Most of these children will have acquired their infection as a result of mother to child transmission (MTCT). This is a growing problem because greater than 90% of women who are HIV positive are of the child bearing age- yet to start or complete their families. The risk of MTCT is generally estimated at between 15 and 40%.
Methods: Review of available literature to highlights current practices in prevention of MTCT in HIV/AIDS.
Results: MTCT can occur during pregnancy – via the placenta, during labour and delivery – through contact of maternal fluids with the baby and during breast feeding – through the breast milk. Factors that will increase the risk of MTCT include: maternal viral load, maternal immune deficiency, placental abruption, invasive ante and intra- partum procedures, mode of delivery and breast feeding.
Prevention of MTCT of HIV will involve; (1) Prevention of transmission from an HIV infected mother to her infant. (2) Prevention of unintended pregnancies in HIV infected women. (3) Prevention of new infections in pregnant women and their partners. And (4) Provision of treatment, care and support to women infected with HIV, their infants and families.
These could be achieved through the use of the anti-retroviral (ARV) drugs- HAART (Highly Active Anti-Retroviral Therapy) or combination of two drugs. Use of safer obstetric practices- Elective caesarean section is preferred but vaginal delivery could be conducted with precaution to reduce risk of transmission especially in women with low viral load. Use of safer infant feeding practices- HIV positive women who opt to breast feed must do so for a short duration and stop if breast inflammation or abscesses occur. Use of condoms especially female condom is recommended to prevent new infections and HIV positive mothers are advised to abstain from sex during antenatal periods to avoid new infections.
Conclusion: Prevention of MTCT will depend on the vigorous implementation of these guidelines


Keywords: Prevention, Mother –to –Child Transmission, HIV

Tropical Journal of Medical Research Vol. 11 (1) 2007: pp. 19-25