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Every minute a child under the age of 15 is infected with HIV. More than ninety percent of children contract HIV through the vertical transmission of the virus from mother to child during pregnancy, birth or breast-feeding. Of the estimated 540,000 children in the world newly infected during 2006, 470,000 live in Africa, and only 700 in either Europe or North America.
Mother-to-child transmission is preventable by giving antiretroviral (ARV) drugs to HIV positive women during their pregnancy and to the infant within a few hours of birth, by carrying out elective caesareans and by providing safe alternatives to breast milk
Wealthy countries have been extremely successful in reducing this mother-to-child transmission (MTCT) to below 1%. However the transmission rate remains as high as 25 to 45%4,5 in poor countries.
This can be attributed to the majority of mothers in poor countries not having access to diagnostic services and appropriate intervention treatments for them or their child. Even where they do, the risk of transmission through breastfeeding remains. Despite these difficulties it has been shown that transmission can be reduced to around 5%6,7, even in breastfeeding populations.
Médecins Sans Frontières is working to break the “transmission chain” in a number of ways. AIDS tests are offered in our pre-natal consultation centres to identify women who are infected. Once a diagnosis has been made appropriate care can be offered to women including ARV drugs, pre-natal care and advice on breast-feeding.
After birth we provide preventative ARV drugs for one week to these babies, then monitor them for infection. If, despite everything, these babies are infected we offer them treatment.
[4] De Cock KM et al. Prevention of mother-to-child-transmission in resource-poor countires: translating research into policy and practice. JAMA, 2000, 283(9):1175-1182
[5] Antiretrovial drugs for treating pregnant women and preventing HIV infection in infants in resource-limited setings. Recommendations for a public health approach, WHO 2006
[6] AIDS 2005 19:309
[7] The DREAM Cohort: Antiretroviral Treatment for PMTCT Abstract: L Palombi, et al. HAART in Pregnancy: Safety, Effectiveness, and Protection from Viral Resistance: Results
from the DREAM Cohort. CROI 2007, Abstract67.