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US Study Suggests Ways to Lower Mother-to-Child HIV Transmission Rate

Lead researcher Andrea Ciaranello told VOA reporter Sithandekile Mhlanga that the mother-to-child HIV transmission rate in Zimbabwe, now at 18 percent in Zimbabwe, could be reduced to 5 percent

US researchers say Zimbabwe's 18 percent rate of mother-to-child transmission of HIV could be brought down to just 5 percent through the use of antiviral drugs like nevirapine by mothers and the elimination or minimization of breastfeeding.

"Eliminating new infant HIV infections in Zimbabwe will require not only improved access to antiviral medications but also support to help HIV-infected mothers continue taking their medication and safely reduce or eliminate breastfeeding," said a release by the Massachusetts General Hospital division of infectious disease.

Lead researcher Dr. Andrea Ciaranello of Massachusetts General said pediatric HIV infection has been nearly eliminated in the United States and Europe, but acknowledged that staying on antiretroviral drugs and avoiding breastfeeding presents significant challenges in Zimbabwe and most other parts of Sub-Saharan Africa.

The study recently published in PLoS Medicine was aimed to evaluate the factors that would be required to meet the World Health Organization objective of the "virtual elimination" of pediatric HIV transmission - reducing it to 5 percent or less.

The study compared Zimbabwe's current prevention program, which provides three-drug antiretroviral drug therapy to pregnant women with advanced HIV infection and a single dose of nevirapine to all others, with two new regimens recommended by the WHO.

"While the existing Zimbabwean program, which reached more than half the country's HIV-infected women in 2009, led to a transmission rate of 18 percent, the authors found that rate could be decreased to 14 percent with even greater participation and the use of newer medications," said the Massachusetts General release.

"Mother-to-child transmission could be further reduced to 6 to 7 percent - approaching 'virtual elimination' - if three goals are reached: more than 95 percent of infected pregnant women receive the most effective available medications; excellent medication adherence is maintained for both mothers and infants throughout pregnancy and breastfeeding; and breastfeeding is safely reduced or avoided altogether."

The authors noted that the reduction or elimination of breastfeeding "requires access to both adequate infant formula and safe drinking water."

Dr. Ciaranello told VOA reporter Sithandekile Mhlanga that the transmission rate could be significantly reduced in Zimbabwe if the recommendations were followed.

But Gibson Mhlanga, principal director in the Health Ministry's preventive services department, said avoidance of breastfeeding in Zimbabwe would compromise the nutrition of new-born babies. Mhlanga noted that exclusively breastfeeding children for the first six-months is recommended by the World Health Organization.

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