Comparison of effectivness of different methods of prevention of mother-to-child hiv transmission

HIV infection among pregnant women is related to the risk of infection transmission to a newborn. The rate of mother-to-child HIV transmission without any prevention may exceed 30% and it increases to about 45% when children are breastfed. First international preventive program based upon ACTG-076 study started in 1994 and caused substantial decrease of frequency of HIV mother-to-child transmission. In Poland almost 25% of HIV infected population are women, and 150 children born in the country have been HIV diagnosed since the very beginning of HIV history. Analyzed group consisted of pregnant women registered in out-patient clinic for HIV patients in Warsaw. There were 718 women registered in the clinic between 1991-2008 and 196 pregnancies were observed in this period. Group was divided according to age group (under 20, 20-30 and over 30 years old), drug abuse status (active user, former user, methadone substitution, never used) and method of prevention (group 1 - none, 2 - ACTG076, 3 - HAART). Most of women were 20-30 years old (76,4%) and majority of them were drug abusers in periods preceding pregnancy (51%). Mother-to-child transmission rate ranged from 34,6% in group 1, 3,96% in group 2 and 0,95% in group 3. The lowest rate, 0% was observed in 60 patients in the group of caesarean section and HAART. Performed analysis confirms that HAART is the most effective method of prevention of mother-to-child HIV transmission.