How Do Hiv Medicines Prevent Perinatal Transmission Of Hiv
Pregnant women with HIV should take HIV medicines to reduce the risk of perinatal transmission of HIV. When started early, HIV medicines can be more effective at preventing perinatal transmission of HIV. Women with HIV who are trying to conceive should start HIV medicines before they become pregnant to prevent perinatal transmission of HIV. Pregnant women with HIV should take HIV medicines throughout pregnancy and childbirth to prevent perinatal transmission of HIV. HIV medicines also protect the womanâs health.
HIV medicines, when taken as prescribed, prevent HIV from multiplying and reduce the amount of HIV in the body . An undetectable viral load is when the level of HIV in the blood is too low to be detected by a viral load test. The risk of perinatal transmission of HIV during pregnancy and childbirth is lowest when a woman with HIV has an undetectable viral load. Maintaining an undetectable viral load also helps keep the mother-to-be healthy.
Some HIV medicines used during pregnancy that pass from the pregnant woman to her unborn baby through cesarean delivery can reduce the risk of perinatal transmission of HIV in women who have a high viral load or an unknown viral load near the time of delivery.
After birth, babies born to women with HIV receive HIV medicines to reduce the risk of perinatal transmission of HIV. Several factors determine what HIV medicines babies receive and how long they receive the medicines.
Mixed Feeding And Mtct Of Hiv
Six studies, 2541 mother-baby pairs, were included in this category of meta-analysis . Except for one study , all other included studies showed the presence of association of mixed feeding with a higher risk of MTCT of HIV. The meta-analysis showed a strong association between mixed feeding and MTCT of HIV, OR=7.46 . The heterogeneity test showed no statistical evidence of heterogeneity I2 =27.2%, p-value=0.231. The Beggs and Eggers test for publication bias also showed no statistical evidence of publication bias, p-value=0.573 and p-value=0.892 respectively .
Fig. 3
Forest plot displaying the association of selected factors with mother to child transmission of HIV in Ethiopia
How Is Hiv Transmitted To A Baby
Transmission is the word for when HIV passes from one person to another.
Mother to baby transmission is also known as vertical transmission.
Most vertical transmissions happen near the time of or during labour and delivery . Vertical transmission also includes transmission through breastfeeding.
The biggest risk factor for vertical transmission is the mothers viral load. This is a measure of how much HIV is in your blood.
The main aim of ART is to get viral load to undetectable. This is the same for everyone with HIV. Viral load tests results are in copies per millilitre . Undetectable viral load is when this gets to less than 50 copies/mL.
When we talk about an undetectable viral load in this guide we mean less than 50. If a mothers viral load is undetectable when her baby is born particularly if this has been the case throughout pregnancy the risk of vertical transmission is almost zero.
Undetectable viral load is particularly important at the time of delivery. Most risk factors for transmission are removed by reducing the amount of HIV in the blood to undetectable.
Practically all risk factors point to one thing: looking after mothers health.
Some key points to remember:
- A mothers health directly relates to the HIV status of the baby.
- Having an HIV positive father will not affect whether the baby is born HIV positive.
- The HIV status of your new baby does not relate to the status of your other children.
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How Can This Affect My Pregnancy
In most cases, HIV will not cross through the placenta from mother to baby. If the mother is healthy in other aspects, the placenta helps provide protection for the developing infant. Factors that could reduce the protective ability of the placenta include in-uterine infections, a recent HIV infection, advanced HIV infection or malnutrition.
Unless a complication should arise, there is no need to increase the number of prenatal visits. Special counseling about a healthy diet with attention given to preventing iron or vitamin deficiencies and weight loss as well as special interventions for sexually transmitted diseases or other infections should be part of the prenatal care of HIV infected women.
Health care providers should watch for symptoms of AIDS and pregnancy complications of HIV infection. In addition, providers should avoid performing any unnecessary invasive procedures such as amniocentesis in an effort to avoid transmitting HIV to the baby.
Effective Treatments Can Reduce Hiv Transmission
When someone with HIV is on antiretroviral treatment and consistently has very low levels of virus they are not infectious and cannot sexually transmit the virus.
This may be true for sexual transmission during pregnancy, but researchers are still gathering more evidence before they can be confident it is true for transmission during pregnancy, labour and delivery, and during breastfeeding.
New preventative medications Pre-exposure prophylaxis and post-exposure prophylaxis can be taken by HIV-negative people who are at risk of getting HIV.
As long as the HIV-positive partner maintains a stable undetectable viral load and these medications are taken strictly as prescribed, HIV transmission to a negative partner is not possible.
Speak to your treating doctor if you would like to explore these newer prevention drugs.
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Reducing Hiv Transmission During Labour
Ways to reduce HIV transmission during birth include:
- Avoiding procedures in labour that may scratch or cut the babys skin, wherever possible .
- Giving antiretroviral medications to the newborn for around 4 weeks after birth.
Caesarean delivery is recommended if a woman:
- Has a detectable viral load, .
- Is not taking antiretroviral treatment.
- Experiences obstetric delivery complications .
- Has other medical illness complications.
Symptoms Of Hiv/aids In Children
Children living with HIV are frequently slow to reach important developmental milestones such as crawling, walking and speaking. Many do not gain weight or grow normally. Like adults living with HIV, children living with HIV can develop life-threatening opportunistic infections. The type of infections is different for children and adults, with serious bacterial infections occurring more often among children.
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How Can Vertical Transmission Be Prevented
There is a set of effective strategies that prevent mother-to-child transmission from taking place. These are called PMTCT: prevention of mother-to-child transmission.
Many women living with HIV have given birth to HIV negative children by taking these precautions:
By doing these things, the chances of the baby having HIV become very low under 1%. If you’re on HIV treatment and have an undetectable viral load, the chances are lower still: 0.1%.
Myth #: Aids Is A Death Sentence
Not anymore. When AIDS was first discovered, there was no effective treatment availableand a diagnosis was ultimately considered a death sentence. Now, this is no longer true, thanks to the development of revolutionary treatment methods. Today, over 27 million people living with HIV are accessing treatment that allows them to live healthy, normal lives. Over the past two decades, the global rollout of treatment has saved nearly 17 million lives from AIDS-related deaths.
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Myth #: You Can Contract Hiv From Touching Someone Who Is Hiv
False. According to the Center for Disease Control, HIV can NOT be transmitted through air, water, saliva, sweat, tears, or sharing a toiletmeaning you cant catch it from breathing
the same air as an HIV-positive person, or hugging, kissing, or shaking hands.
The virus can only be transmitted through certain body fluids like blood, semen, vaginal fluid, rectal fluid, or breast milk. Therefore, its often transmitted through sex, when protection is not used, or through needle or syringe use. The virus can also be passed from mother to child during pregnancy, if the mother is not accessing antiretroviral medication. This is why it is so critical to ensure pregnant mothers living with HIV not only get tested, but can access and adhere to treatment throughout pregnancy and during breastfeeding.
In instances of sex between an HIV-positive and an HIV-negative partner, condoms are highly effective in preventing the transmission of HIV. When condoms are paired with antiretroviral medication, they provide even more protection. And with the introduction of new medication and treatment like PrEP and long-lasting injectables, the most-at-risk communities are able to further protect themselves from contracting HIV.
How Is Hiv Transmitted Or Spread
The following are the means by which the HIV virus is spread:
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Vertical transmission. HIV can be spread to babies born to, or breastfed by, mothers infected with the virus.
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Sexual contact. In adults and adolescents, HIV is spread most commonly by sexual contact with an infected partner. The virus enters the body through the lining of the vagina, vulva, penis, rectum, or abraded or irritated tissues in the lining of the mouth through sexual activity.
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Blood contamination. HIV may also be spread through contact with infected blood. However, due to the screening of donated blood for evidence of HIV infection, the risk of acquiring HIV from blood transfusions is extremely low.
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Needles. HIV is frequently spread by sharing needles, syringes, or drug use equipment with someone who is infected with the virus. Transmission from patient to health care worker, or vice-versa, through accidental sticks with contaminated needles or other medical instruments, is rare.
No known cases of HIV/AIDS have been spread by the following:
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Saliva
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Malaise
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Enlarged lymph nodes
An HIV-infected child is usually diagnosed with AIDS when the immune system becomes severely damaged or other types of infections occur. As the immune system deteriorates, complications begin to develop. The following are some common complications, or symptoms, of the onset of AIDS. However, each child may experience symptoms differently. Symptoms may include:
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Are Hiv Medicines Safe To Use During Pregnancy
Most HIV medicines are safe to use during pregnancy. In general, HIV medicines do not increase the risk of birth defects. Health care providers discuss the benefits and risks of specific HIV medicines when helping women with HIV to decide which HIV medicines to use during pregnancy or while they are trying to conceive.
How Can We Conceive If One Of Us Is Hiv Negative And One Is Living With Hiv
When a person living with HIV has an undetectable viral load, there is no risk of HIV transmission during sex. Providing the partner living with HIV has an undetectable viral load and neither of you have any sexually transmitted infections , sex without a condom is fine.
If you or your partner have a detectable viral load, it is important to discuss conception options that reduce or remove risk of transmission during sex to you/your partner and baby. Before deciding not to use condoms, get advice from your HIV healthcare team so that they can confirm what would work best for you. This may include the HIV-negative partner taking PrEP. PrEP reduces HIV transmission and is safe to take during pregnancy and breastfeeding.
Everyone planning a pregnancy whether or not they have HIV is advised to take a daily folic acid supplement whilst trying to conceive and for the first 12 weeks of pregnancy. Folic acid helps cells in the body to develop. It is difficult to get enough through diet alone.
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What Is Perinatal Transmission Of Hiv
Perinatal transmission of HIV is when HIV is passed from a woman with HIV to her child during pregnancy, childbirth , or breastfeeding . Perinatal transmission of HIV is also called mother-to-child transmission of HIV.
The use of HIV medicines and other strategies have helped to lower the rate of perinatal transmission of HIV to 1% or less in the United States and Europe.
Home Delivery And Mtct Of Hiv
Five studies, 2115 mother-baby pairs, were included in this category of meta-analysis . Three of the included studies showed a significant association between home delivery and a higher risk of HIV transmission from mother to the child. Two studies showed no such association . The pooled meta-analysis showed higher odds of MTCT of HIV among HIV positive women who gave birth at home than women who delivered at health facilities in the presence of skilled birth attendants, OR=5.08 . Significant heterogeneity was found. Whereas, the Beggs and Eggers tests showed no statistical evidence of publication bias, p-value=0.142 and p-value=0.055, respectively .
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Getting Pregnant When A Male Partner Is Hiv
If a male partner is HIV-positive, a procedure called sperm washing can be used to conceive. During this procedure a machine separates sperm cells from the seminal fluid, which can carry the virus. The washed sperm is then used to fertilise the womans egg using a special catheter inserted into the uterus.
If the male partner is on effective treatment and has a stable undetectable viral load, there is no risk of HIV transmission.
In-vitro-fertilisation may also be an option.
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- HIV can pass from mother to baby during pregnancy or birth or via breastmilk.
- Due to treatment advances, mother to child transmission of HIV is very rare in Australia.
- With medical support, the HIV transmission rate from mother with HIV taking antiretroviral treatment to their unborn child is 1% or less in Australia.
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How Does Hiv Treatment Prevent Mother
Everyone with HIV is now recommended to start treatment at diagnosis whatever their CD4 count.
There are two different ways in which anti-HIV drugs act to prevent MTCT:
- They reduce your viral load so your baby is exposed to less HIV while in the womb and during birth. The aim of HIV treatment is to get, and keep, your viral load to undetectable levels.
- Some anti-HIV drugs cross the placenta and enter your babys body, preventing the virus from ever taking hold. Newborn babies are given a short course of anti-HIV drugs after theyre born when their mother is known to be HIV positive.
You can reduce the risk of HIV transmission further by having a managed delivery. Your doctor will look at your viral load when you are 36 weeks pregnant and discuss options with you.
Is Hiv Testing Recommended For Pregnant Women
The Centers for Disease Control and Prevention recommends that all women get tested for HIV before they become pregnant or as early as possible during each pregnancy. The earlier HIV is detected, the sooner HIV medicines can be started.
All women who are pregnant or trying to get pregnant should encourage their partners also to get tested for HIV and, if possible, screened for other sexually transmitted diseases . STDs can increase viral loads in people with HIV. If any partner has HIV, that partner should take HIV medicine as prescribed to stay healthy and prevent transmission.
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Reducing The Risk Of Passing Hiv To Your Baby
If you have HIV, you can reduce the risk of passing it to your baby by:
- taking antiretroviral drugs during pregnancy, even if you don’t need HIV treatment for your own health
- considering the choice between a caesarean or vaginal delivery with your doctor
- bottle feeding your baby, rather than breastfeeding
- your doctor prescribing your baby antiretroviral drugs for up to 4 weeks after they have been born
Do not breastfeed your baby if you have HIV, as the virus can be transmitted through breast milk.
Transmission Of Hiv From Mother
If a mother is HIV+ and was on medications which would help her deliver a HIV negative baby, can the baby contract the HIV through her breast milk?
- 1$\begingroup$Hi there and welcome to biology.S.E. Currently the question is a bit unclear. To try to move this away from being to hypothetical, what medication is the mother taking? Also note that this site shouldn’t be used to seek personal medical advice.$\endgroup$ JamesOct 23 ’15 at 7:29
- $\begingroup$I am not seeking personal medical advice ,i was just curious to know.Thanks for the answer$\endgroup$
In short, yes. Breast milk can contain virions which can be transferred from Mother-to-Child.
These are the guidelines from the National Institute of Health in the United States regarding the Prevention for Mother-to-Child Transmission of HIV and how the prevent Mother-to-Child Transmission of HIV After Birth
Italics in previous paragraph indicate an edit to the answer in order to clarify the reason why breastfeeding is recommended in lesser developed countries, even though it poses a risk for HIV transmission
Please note that these guidelines are in flux and as more evidence is obtained and as the virus mutates, things may change. It is always best to consult with a physician on the most current recommendations in the care of your infant if you are HIV+.
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How Will Hiv Affect My Labor And Birth
If no preventative steps are taken, the risk of HIV transmission during childbirth is estimated to be 10-20%. The chance of transmission is even greater if the baby is exposed to HIV-infected blood or fluids. Health care providers should avoid performing amniotomies , episiotomies and other procedures that expose the baby to the mothers blood. The risk of transmission increases by 2% for every hour after membranes have been ruptured.Cesarean sections performed before labor and/or the rupture of membranes may significantly reduce the risk of perinatal transmission of HIV.Women who have not received any drug treatment before labor should be treated during labor with one of several possible drug regimens. These may include a combination of ZDV and another drug called 3TC or Nevirapine. Studies suggest that these treatments, even for short durations, may help reduce the risk to the baby.