HIV is the end of the world for many. However, technology today can do some amazing things. When you hear that HIV-positive women delivered healthy, HIV-free babies in India, you know that someone, somewhere, is making the world a better place.
A couple of decades ago, HIV+ diagnosis was easily the most dreaded, along the lines of cancer. The immune deficiency, propensity for infection, and the genetic nature of HIV, only added to its already notorious reputation.
This fact was corroborated by the 2007 Environmental and Occupational Medicine Journal, which published a study stating that HIV transmits from a mother to her child either during pregnancy, delivery or through breast milk. Genetic transmission accounted for the third most common way of HIV infection globally. Without drug intervention, one out of two such children can develop AIDS.
To check the validity of this claim, the University of KwaZulu-Natal, and the University of Massachusetts conducted a combined study on the prevention of vertical transmission of HIV-1 in resource-limited settings. The study concluded that with the right line-of-treatment, the risk of vertical, or mother-to-child transmission can be lowered to 1%.
Typically, controlled studies often fail to paint a realistic picture of the world. However, a couple of days ago in Mumbai, a state-administered hospital reached the unique milestone of delivering 100 infection-free babies from moms who tested HIV+.
JJ Hospital is considered the last chance saloon for HIV+ expectant moms who suffer the ignominy of being turned away by other hospitals. The institution has been working on reducing mother-child transmission for a little over 15 years.
Dr. Rekha Daver, head of the JJ Hospital Gynecology department and member of the National AIDS Control Organisation (NACO) task force says, “We have been working on reducing mother-to-child transmission of HIV since 2000. But, we have been pleasantly surprised to note that 100 children born since the start of the three-drug regimen (Tenofovir, Lamivudine, and Efavirenz) are HIV-free.”
The milestone, rightly so, is a cause for celebration. The decision of the health ministry to place such women under a unique anti-HIV plan during their pregnancy has helped immensely. But the road to this milestone has been a learning curve.
Back in 2000, JJ Hospital began administering one Nevirapine tablet to both the baby and her mother. This helped reduce the initial risk of transmission, but the moms developed a tolerance for the drug. Around seven in 100 children developed HIV later in life.
More recently, the Indian Ministry of Health finally acquiesced to WHO’s Option B+, a three-drug daily dose designed to reduce viral presence in the body. The Government went one step further, combining the three chemicals to create a single drug. The medication has shown some encouraging signs. Dr. Daver added that many women could even nurse their child without fearing HIV transmission.
Dr Srikala Acharya agreed that the drug has shown some rather heartening signs. “In the past two years, we have had less than 5% positive births among our HIV-positive mothers,” she said.
NACO’s national programme officer Dr BB Rewari shared, “The TLE (Tenofovir, Lamivudine and Efavirenz) regimen has helped decrease HIV transmission rates to 2% across India’s centres.
All isn’t rosy, though. It is estimated that around 35,000 HIV+ women become pregnant annually, but a little more than a third of them don’t make it to hospitals or medicines in time.