J J Hospital’s gynaecology department has scored a perfect 100 in one of its most trying tasks: delivering 100 HIV-free babies of HIV-positive mothers since March 2014.
The hospital is considered a referral centre for HIV-positive pregnant women who are turned away from other hospitals.
“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,” said Dr Rekha Daver. She heads JJ Hospital’s gynaecology department and is on the National AIDS Control Organisation task force.The mother-to-child transmission (MTCT) of HIV refers to the transmission of HIV from an HIV-positive woman to her child during pregnancy, labour, childbirth or breastfeeding. MTCT is by far the most common way that children become infected with HIV (90%).
Between 2001 and 2002, India started giving a single dose (of Nevirapine tablet) to pregnant women and the newborn. “This helped cut down the transmission risk to a great extent, but the mothers risked developing drug resistance later on,” said Dr. Daver. Moreover, 7% of the children born to HIV-positive mothers in J J Hospital contracted the virus under the Nevirapine regimen; the national average was higher at 11%.
In 2014, India accepted the World Health Organisation’s Option B+ that entails pregnant women taking the three drug dose daily to reduce the viral load in their bodies. In September 2015, the WHO released new guidelines recommending lifelong antiretroviral treatment (ART) for all pregnant and breastfeeding women living with HIV.The 2015 guidelines recommend Option B+ where lifelong ART is provided to all pregnant and breastfeeding women living with HIV regardless of CD4 count or WHO clinical stage. ART should be maintained after delivery and completion of breastfeeding for life. “To ensure women take the drugs daily, the government has worked out a single tablet of these three drugs to be taken before sleeping every night,” said Dr Daver.As a result, the viral load among the mothers fell to negligible levels.