Lifelong antiviral treatment appears to prevent the spread of viral transmission from mother to child

Anti-retroviral drugs are an essential tool in the prevention and treatment of HIV. A new study of pregnant women in Tanzania shows that lifelong antiviral treatment also appears to prevent mother – to – child transmission of viral transmission. The results of the study, conducted in part by researchers at Karolinska Institutet in Sweden and published in Lancet HIV, promisingly contribute to the WHO work with HIV prevention in low- and middle-income countries.

Just over eight years ago, the World Health Organization (WHO) issued recommendations called Option B + for simpler and more effective prevention and treatment for HIV during and beyond pregnancy in low-income countries. low and middle input. One arm of the Choice B + program involved ensuring that HIV-pregnant women were started on a lifelong program of antiviral drugs, ART, as early as possible during pregnancy. Option B + made significant progress in preventing the transmission of HIV from mother to child.

Lifelong lifelong ART intervention can also provide effective protection against progression to more advanced HIV and early death, and prevent further infection of partners and children in the future. To date, however, little research has been conducted on how treatment affects long-term viral rates in HIV-pregnant women in low- and middle-income countries with a high HIV burden.

Now, researchers at Karolinska Institutet, Muhimbili University of Health and Allied Sciences and Management and Development for Health, have studied the time-over efficacy of B + Option interventions in Tanzania. According to UNAIDS figures from 2019, 4.8 percent of the Tanzanian population between the ages of 15 and 49, that is 1.7 million people, are living with HIV.

The study, conducted in Dar es Salaam – Tanzania’s largest city – included patient data for 10,161 HIV-pregnant women who had started antiviral treatment on the Option B + program to prevent viral transmission to their unborn babies. At the time data were collected, 5.9 percent of the city’s pregnant women who started prenatal care were HIV-positive. About a third of the study participants had advanced HIV infection.

The researchers measured the level of HIV in the women’s blood to measure the effectiveness of antiviral treatment over time. The data were collected between 2014 and 2016, and the females were monitored for up to four years.

The results showed that up to 90 percent of the women surveyed had viral levels that increased up to four years after starting Option B + care. In other words, it seems possible that the WHO goal of reversing the transition from mother to child is possible.

Our study confirms the enduring health benefits of lifelong ART for women who go on Option B + during pregnancy and therefore for their babies as well. The results also highlight some other important challenges when it comes to reaping the full long-term benefits of Option B +. To focus, for example, on some subgroups of women, such as young mothers, mothers who start antenatal care late in pregnancy and mothers with advanced HIV. “

Goodluck Lyatuu, Doctor and Doctoral Student, Department of Global Public Health, Karolinska Institutet, and first author at Study