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5 December, 2016 00:00 00 AM

HIV/AIDS from mother to child

HIV/AIDS from mother to child

Human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS) is a spectrum of conditions caused by infection with the human immunodeficiency infection (HIV). Following initial infection, a person may not notice any symptoms or may experience a brief period of flu-like illnesstypically; this is followed by a prolonged period with no symptoms. As the infection progresses, it interferes more with the immune system,  increasing the risk of common infections like tuberculosis, as well as weight loss, tumors and infections. These late symptoms of infection are referred to as AIDS. .
 In 2015 about 36.7 million people were living with HIV. Between its discovery and 2014 AIDS has caused an estimated 39 million deaths worldwide.
HIV/AIDS has had a great impact on society, both as an illness and as a source of discrimination. The disease also has large economic impacts. It has attracted international medical and political attention as well as large-scale funding since it was identified in the 1980s.
AIDS stigma exists around the world in a variety of ways, including, discrimination and avoidance of HIV infected people; compulsory HIV testing without prior information and confidentiality; violence against HIV infected individuals or people who are perceived to be infected with HIV; and the segregation of HIV infected individuals. Stigma-related violence or the fear of violence prevents many people from seeking HIV testing, returning for their results, or securing treatment, possibly turning what could be a manageable chronic illness into a death sentence and perpetuating the spread of HIV .Often, AIDS stigma is expressed in conjunction with one or more other stigmas, particularly those associated with prostitution, homosexuality,and I.Vdrug abuse.
HIV is transmitted by three main routes: sexual contact , significant exposure to infected body fluids or tissues and from mother to child during pregnancy, delivery, or breastfeeding (known as vertical transmission. There is no risk of acquiring HIV if exposed to feces, nasal secretions, saliva, sputum, sweat, tears, urine, or vomit unless these are contaminated with blood.It is possible to be co-infected by more than one strain of HIV—a condition known as    HIV super infection.
The second most frequent mode of HIV transmission is via blood and blood products Blood-borne transmission can be through needle-sharing during intravenous drug use, needle stick injury, transfusion of contaminated blood or blood product, or medical injections with unsterilized equipment.
The risk from sharing a needle during drug injection is between 0.63 and 2.4% per act, with an average of 0.8%. The risk of acquiring HIV from a needle stick from an HIV-infected person is estimated as 0.3% (about 1 in 333) per act and the risk following mucous membrane exposure to infected blood as 0.09% (about 1 in 1000) per act.
HIV can be transmitted from mother to child during pregnancy, during delivery, or through breast milk resulting in infection in the baby This is the third most common way in which HIV is transmitted globally In the absence of treatment, the risk of transmission before or during birth is around 20% and in those who also breastfeed 35%.
As of 2008, vertical transmission accounted for about 90% of cases of HIV in children. With appropriate treatment the risk of mother-to-child infection can be reduced to about 1%.Preventive treatment involves the mother taking antiretroviral during pregnancy and delivery, and administering antiretroviral drugs to the newborn.
HIV medicines work by preventing HIV from multiplying, which reduces the amount of HIV in the body. Having less HIV in the body reduces a woman's risk of passing HIV to her child during pregnancy and childbirth. Having less HIV in the body also protects the woman's health.
Some of the HIV medicine passes from the pregnant woman to her unborn baby. This transfer of HIV medicine protects the baby from HIV infection, especially during a vaginal delivery when the baby passes through the birth canal and is exposed to any HIV in the mother’s blood or other fluids.
In some situations, a woman with HIV may have a cesarean delivery (sometimes called a C-section) to reduce the risk of mother-to-child transmission of HIV during delivery.
Prevention of mother-to-child transmission (PMTCT) programsprovides antiretroviral treatment to HIV-positive pregnant women to stop their infants from acquiring the virus.
Guidelines for pregnant and breastfeeding women living with HIV
The 2015 guidelines recommend Option B+ where lifelong antiretroviral treatment is provided to all pregnant and breastfeeding women living with HIV regardless of CD4 count or WHO clinical stage. Treatment should be maintained after delivery and completion of breastfeeding for life.
Programs ofprevention (from mothers to children) can reduce rates of transmission by 92–99%. This primarily involves the use of a combination of antiviral medications during pregnancy if replacement feeding is acceptable, feasible, affordable, sustainable, and safe, mothers should avoid breastfeeding their infants; however exclusive breastfeeding is recommended during the first months of life if this is not the case. If exclusive breastfeeding is carried out, the provision of extended antiretroviral prophylaxis to the infant decreases the risk of transmission
Guidelines for HIV-exposed infants
All infants born to HIV-positive mothers should receive a course of antiretroviral treatment as soon as possible after birth. The treatment should be linked to the mother's course of antiretroviral drugs and the infant feeding method.Babies born to women with HIV receive HIV medicine for 4 to 6 weeks after birth. The HIV medicine reduces the risk of infection from any HIV that may have entered a baby’s body during childbirth.
Breastfeeding - the infant should receive once-daily nevirapine from birth for six weeks.
Replacement feeding - the infant should receive once-daily nevirapine (or twice-daily zidovudine) from birth for four to six weeks.
The first country in the world to eradicate mother-to-child transmission of HIV is Cuba in 2015.
Currently, there is no licensed Vaccinefor HIV or AIDSThe most effective vaccine trial to date, RV 144, was published in 2009 and found a partial reduction in the risk of transmission of roughly 30%, stimulating some hope in the research community of developing a truly effective vaccine.
Further trials of the RV 144 vaccine are ongoing.
Even though there are no vaccines to prevent or cure HIV, people with HIV can benefit from vaccines against other diseases.Testing is underway on experimental vaccines to prevent and treat HIV/AIDS, but no HIV vaccines are approved for use outside of clinical trials.

The following vaccines are recommended for people with HIV:
Hepatitis B
Influenza (flu)
Pneumococcal (pneumonia)
Tetanus, diphtheria, and pertussis (whooping cough). A single vaccine called Tdap protects adolescents and adults against the three diseases. Every 10 years, a repeat vaccine against tetanus and diphtheria (called Td) is recommended.
Human papillomavirus (HPV.)



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Editor : M. Shamsur Rahman

Published by the Editor on behalf of Independent Publications Limited at Media Printers, 446/H, Tejgaon I/A, Dhaka-1215.
Editorial, News & Commercial Offices : Beximco Media Complex, 149-150 Tejgaon I/A, Dhaka-1208, Bangladesh. GPO Box No. 934, Dhaka-1000.

Editor : M. Shamsur Rahman
Published by the Editor on behalf of Independent Publications Limited at Media Printers, 446/H, Tejgaon I/A, Dhaka-1215.
Editorial, News & Commercial Offices : Beximco Media Complex, 149-150 Tejgaon I/A, Dhaka-1208, Bangladesh. GPO Box No. 934, Dhaka-1000.

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