Friday, January 22, 2021

Mother to child HIV transmission lowest in Botswana

International researchers, in collaboration with the Ministry of Health, have discovered that anti retroviral drugs given to pregnant and breastfeeding mothers in Botswana reduce mother to child transmission of HIV by 99%. The ground breaking discovery, which is the lowest in Africa, was made after a clinical study led by Robert Shapiro, Associate Professor of Medicine at Harvard Medical School, researchers at the Harvard School of Public Health, Botswana Harvard Partnership and the MoH.

In a communiqu├® to Sunday Standard, Dr Joseph Makhema, Project Director at BHP, said the study’s transmission rate of 1.1% was obtained after breastfeeding children to age six months. This is the lowest rate of mother to child transmission recorded in a study from Africa or among breast feeding infants.

“Previous interventions using shorter or less comprehensive treatment regimes were unable to get rates below 5%. Without any intervention, the rate of infection would be at least 25 % by age six months” said Dr. Makhema.

While breastfeeding is the ideal way to feed infants, it can also transmit HIV. Breast milk provides all of the nutrients needed during the first few months of life, and it also contains agents that help to protect against common childhood illnesses such as diarrhoea and respiratory infections. In Africa, it is estimated that between one third and one half of infant HIV infections are due to breastfeeding. For many years, African women who are infected with HIV had to make the difficult choice of not breastfeeding their children to prevent infections on the one hand, and watching them experience stunted growth as a result of not being breast fed. For many of them, there were no easy options. To that extent, the latest discovery is very encouraging.

Very little was known about the ability of Highly Active Anti-retroviral Therapy (HAART) to halt HIV transmission from mother to infant through breastfeeding, especially in Sub-Saharan Africa, where formula feeding is neither safe nor feasible.

The study involved 730 infected pregnant women, and most started HAART treatment early in the third trimester of pregnancy. Almost all of them achieved viral suppression by delivery, and their virus remained undetectable throughout breastfeeding.

In Southern Africa the rate of HIV infection is 3 to 5 times higher than in the rest of Africa and over 100 times higher than in the rest of the world.

Children who are HIV infected are much less likely to be in treatment programs, and would most likely die of HIV-Aids related infections at an early age. This makes it even more critical that effective measures are available to prevent them from becoming infected.

According to Dr. Makhema, the research findings are already making international wavelengths and influencing the World Health Organisation’s guidelines on the use of HAART to prevent mother to child transmission.

“For the first time, WHO recently recommended that all HIV infected mothers or their infants take ARV’s while breastfeeding to prevent HIV transmissions” he said.

The Botswana government is already preparing a roll out program to provide HAART to all pregnant women with HIV, and other countries are considering doing the same” said Dr. Loeto Mazhani, a paediatrician and Assistant Program Director at the University Of Botswana School Of Medicine.

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