Pregnancy and transmission of HIV

It is utmost importance that a mother should be aware of the possibility of HIV transmission to her baby. She should be undergone test before or on the onset of pregnancy so that sufficient precautions can be taken for prevention of perinatal HIV infection. Without proper treatment up to 30% of babies infected with HIV may born to the women having HIV positive. Moreover after delivery up to 20% babies may be infected with HIV through breast-feeding.

Transmission of HIV
HIV or Human Immunodeficiency Virus causes AIDS or Acquired Immune Deficiency Syndrome. Although HIV is mostly passed from one person to another through sexual contact, but it also spreads through body fluids like blood, semen, vaginal fluid, breast milk. HIV is usually transmitted through sharing needles, unprotected anal, vaginal and sometimes oral sex and from mother to infant before or during delivery or while breastfeeding.

How HIV pass on to baby from mother
Baby may get infected with HIV in the womb, in the vaginal passage and through breast milk. Transmission of HIV to baby may take place during pregnancy, during labor and during delivery or after delivery through breast feeding.
During pregnancy, the mother’s antibodies against HIV are passed on to her baby. So some babies of women with HIV may test positive for HIV antibodies at first. This does not necessarily imply that the baby is infected. The baby’s immune system will start making antibodies of their own only between 6 and 18 months of age. If the baby is infected with HIV, he or she will still lose the mother’s antibodies, but the baby will start to make antibodies to HIV. The baby will test positive and continue to test positive for HIV.

Tests
The CD4 test gives the immunological status while the viral load test gives information about the severity of infection. These results guide the clinician when to initiate therapy and regimens to be adopted. Other advanced tests like PCR and viral culture can also be used to check babies for HIV infection depending on availability of tests.

Prevention
Voluntary testing and counseling is required for preventing HIV infection among parents. HIV positive women should avoid unwanted pregnancies and access to antiretroviral therapy, safe delivery practices, and the widespread availability and safe use of breast-milk substitutes are the effective ways of prevention of mother to child transmission. Since HIV is found in breast milk, so there is a chance to pass HIV to the baby. Boiled milk can be fed to baby to stop the transmissions of HIV as heat can destroy the HIV. Shorter period of delivery time can decrease the chance of transmission of HIV. Mothers with a high viral load might reduce their risk if they give birth their baby by cesarean section. This helps in protecting the child from direct contact with her blood and other bodily fluids. Antiretroviral can minimize the possibility HIV transmission to baby. ARVs are assumed to be safer for the baby but long-term effects are as yet unknown. The earlier HIV is diagnosed during, before or after pregnancy, the better are the chances of success. The most important time for an HIV positive pregnant woman to take ARVs is during labor. Transmission rates are only 1% to 2% if the mother takes combination antiretroviral therapy