A news release by the National Institutes of Health in the US (NIH) dated 18th July 2016 reported that HIV-positive women who took a three-drug antiretroviral treatment did not pass the HIV virus to their newborn babies. The study, Promoting Maternal and Infant Survival Everywhere (PROMISE) funded by the NIH supports similar findings by the World Health Organization that endorses antiretroviral therapy for HIV-infected expectant and breastfeeding women in order to reduce the chances of mother-to-child HIV transmission.

The researchers found that two sets of treatment were both safe and effective in preventing passing on the virus from the mother to the child during breastfeeding; three-drug maternal antiretroviral therapy and daily infant nevirapine. The number of infant deaths was relatively low in the study with virtually all babies surviving through the first year of life.

The study population drawn from clinical research sites in India, Malawi, South Africa, Tanzania, Uganda, Zimbabwe and Zambia included 2431 HIV positive women and their HIV uninfected babies for a period of 3 years as from June 2011 to October 2014.

Triple-drug antiretroviral therapy and Nevirapine Regime

The trial involved unsystematically giving the mothers one of the two regimens of the triple-drug antiretroviral therapy and daily doses of the nevirapine. The subjects were then followed up for a period of 18 months or until breastfeeding stopped.

PROMISE researchers got the following results from the trial:

1. The 3-drug antiretroviral therapy given to the women prevented mother-to-child transmission.
2. Nevirapine given to the infants also prevented mother-to-child transmission.
3. Transmission rates ranged from 0.3% at 6 months to 0.6% at 12 months.

The director of NIH’s National Institute of Allergy and Infectious Diseases affirmed that the study continues to prove the wonderful advantages that people living with HIV benefit from antiretroviral therapy. Case in point, the antiretroviral therapy given during the study ensured that the mothers did not pass on the virus to their babies while preserving the health benefits of breastfeeding and in a safe manner.

Drug Reduces Transmission Rates to 5%

WHO states that the transmission rates which range from 15% to 45% in the absence of any intervention can be reduced to below 5% if women are able to get the necessary medical help during prenatal and postnatal periods. In addition, increased campaigns to give ART to expectant women was one of the contributing factors towards the success of the Global Plan in the elimination of new HIV infections among children as well as keeping their mothers alive and healthy by 2015.

It is reported that many nations saw the number of new HIV infections in children drop by over 60% from 2009 to 2014. For these nations, mother-to-child transmission of HIV is almost a thing of the past as they are very close to eliminating it as a public health concern.

Yet another NIH report states that the three-drug regimen for the mother out of all the others is the best in preventing mother-to-child transmission.

Through the PROMISE program that has been in existence for the past 6 years, more clinical trials are continuing across the globe especially in places that mother-to-child transmission rates are high. The program continues to put efforts towards finding the best ways to securely and efficiently reduce mother-to-child transmission of the virus.

Prevention and Testing

It is amazing that we are making such great progress in normalizing the lives of those living with HIV but it is still not easy nor cheap. Prevention is key and we do advocate the use of condoms and even abstinence. If one has a has a sexual lifestyle that is high risk, frequent STD testing that includes a HIV test at a trusted STD clinic in Singapore should be made part of the lifestyle as well.

Exposure

If you have been exposed within the last 72 hours, do quickly make an appointment with Shim clinic for HIV PEP treatment to prevent yourself from being infected. If you know you are going to engage in sexual activities with someone who is HIV positive, consider HIV PrEP as well.