Date: 10 December 2009
Source: IRIN PlusNews
The percentage of HIV-positive mothers who pass the virus to their newborn babies in South Africa's KwaZulu-Natal Province has dropped by nearly two-thirds since dual antiretroviral (ARV) therapy was introduced in January 2008 for the prevention of mother-to-child transmission (PMTCT). Before this, pregnant HIV-positive women were given a single dose of nevirapine during labour, and their babies received a dose at birth. With dual therapy, HIV-positive women receive the ARV drug, zidovudine, from 28 weeks of pregnancy, as well as a single dose of nevirapine. Their babies receive zidovudine for seven days after birth, and a dose of nevirapine. A study conducted in six districts of KwaZulu-Natal between 2008 and 2009, revealed that the province rapidly implemented the revised PMTCT guidelines, bringing down transmission to as low as 4.3% in one district, and 7% on average. 36% of the 38,000 mothers tested HIV-positive. Two-thirds of these women received dual therapy, 14% received nevirapine only, and 13% started ARV treatment. 8,013 babies aged between four weeks and eight weeks were tested for HIV, and of those whose mothers had received dual therapy, 5.6% were HIV-positive compared to 13.5% of babies whose mothers only received nevirapine. The new higher CD4 count threshold for starting HIV-positive pregnant women on ARVs could bring down mother-to-child transmission rates to below 2%, but the new guidelines would place "a very major burden on the health system", according to the study's lead investigator. There are plans to replicate the KwaZulu-Natal study in the country's eight other provinces, using the same methodology.
