Taking Notes from the UK About Lowering Mother-to-Child HIV Transmission Rates

Progress to prevent perinatal transmission of the human immunodeficiency virus (HIV) has come a long way. Nowadays, as long as an HIV-positive pregnant woman takes her medication as prescribed during pregnancy, labor, and delivery, as well as give her baby medication for four to six weeks, the chances of passing on the virus can be 1% or less. Even still, children are still born with the infection all over the world. The United Kingdom and Ireland, however, have reached a record low rate of perinatal HIV transmissions.

Researchers from the University College London (UCL) unwrapped just how this happened. The verdict? Very high antenatal HIV screening and treatment in pregnant women in order to reduce viral loads.

About 97% of pregnant women in the UK are screened for HIV, according to a UCL news release. Around 90% of HIV-positive pregnant women have achieved undetectable viral loads.

According to the National Study of HIV in Pregnancy and Childhood, only seven babies born to HIV-positive mother (0.27%) in the UK were infected from 2012 to 2014. That percentage measured in at 0.46% from 2010 to 2012 and 2.1% in 2000 to 2001.

“It is uncertain whether the transmission rate will decline further. We are continuing to monitor this as well as the circumstances around the small number infant infections, which tend to be highly complex,” said Clair Thorne, PhD, one of the research authors.

In the United States, healthcare providers can approach pregnant women with the opt-in method (pre-HIV counseling followed by agreeing to testing) or the opt-out method (the HIV test is included in prenatal tests, but women may decline it).

A mother can transmit HIV to her child during pregnancy, labor, or breastfeeding, however, with sufficient testing and treatment, that risk dramatically drops. The majority of the 174 American children diagnosed with HIV in 2014 in the US acquired the infection from their mothers. The Centers for Disease Control and Prevention (CDC) found that about 17 out of 100,000 live births in 2012 had perinatally acquired HIV infections in the United States — around 15 of the mothers were African American.

“To maintain, or possibly improve on the current rate requires continued early testing for HIV in pregnancy and appropriate support for all women living with HIV — before, during, and after their pregnancy,” Thorne said.

The research letter, “UK Mother to Child HIV Transmission Rates Continue to Decline: 2012-2014,” was published in the journal, Clinical Infectious Diseases.

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