Prevention of Parent To Child Transmission of HIV

HIV infection has become a global pandemic. It has already killed 20 million people since the beginning of the epidemic and it has infected 36 million people, almost half of them are women and majority of them are in the child bearing  age group. About 5 million children have acquired HIV infection and more than 90% is through mother to child transmission.

In India there are about 25 million births every year and the average sero prevalence rate of HIV during pregnancy is around 1% and with the risk of transmission from mother to child being 25-30%, it has been estimated that about 7,00,000 HIV infected neonats are born every year. In other words, about 1,600 babies are born with HIV infection daily.

The transmission of HIV infection could occur during pregnancy, delivery and through breast-feeding.

Considering the importance of this mode of transmission, Govt. of India (NACO) has decided to scale up Presentation of Parent to Child Transmission of HIV. (PPTCT Programme) in the entire country in a phase manner. Induction training of the PPTCT team from J. N. Medical College, Belgaum was done in the month of April 2002 and the team comprised of Dr. V. D. Patil, Consultant Paediatrician ; Dr. Shobhana S. Patted, Consultant Obstetrician & Gynaecologist; Dr. C. S. Patil, Chief Microbiologist; Dr. Anjali Joshi, Counselor & Mrs. Meena Chavan, Senior Staff Nurse.

The PPTCT Programme has been implemented at K.L.E. Society’s Hospital and Medical Research Centre, Belgaum, from 2nd September 2002. A counselling room has been established in the OPD Block - Dept. of OBG (Room No. 10), K.L.E. Society’s Hospital and Medical Research Centre, Belgaum. All pregnant women attending antenatal clinic are encouraged to undergo group education session through a structured talk. The talk emphasis on routine prenatal care advice and key HIV messages are normally highlighted. At the end of session all women are offered HIV testing after obtaining informed Consent. If test result is positive then the counseling is done on an one to one basis. The issues of partner notification, intervention to reduce MTCT, role of antiretroviral drugs are discussed. Confidentiality is maintained.

During the delivery the expectant mother is given Tab. Nevirapine , 200 mg single dose, and the baby is given Nevirapine syrup 2 mg/kg within 72 hrs after the birth as single dose. The mother is counseled about perinantal transmission through breast milk. Ideally top milk is preferred rather than breast feeding.

Dr. V. D. Patil

Principal and Professor and HOD of Paediatrics,
Chairman PPTCT Programe,
J. N. Medical College, Belgaum.

Dr. Shobhana S. Patted

Consultant Obstetrician Co-Ordinator,
PPTCT Programe,
J. N. Medical College, Belgaum.