by Dr. Seema Alavi on May 25, 2011 at 12:53 PM
Keeping in mind the escalating incidence of HIV
transmission, the WHO has recommended certain important steps for preventing
its transmission via mother-to-child and ensuring their survival.
The eradication of HIV transmission from
mother-to-child is regarded as a surmounting concern by the WHO and has been
included in the millennium development goals as the one of the prime
Both the mitigation of the risk of mother-to-child
HIV transmission and the maintenance of the health of the mother and child are
of utmost importance and most sought after concerns of the interventions across
In 2006, various important evidences arose with WHO
issuing improvised guidelines on the application of antiretroviral (ARV)
prophylaxis to reduce MTCT. It involved period of breast feeding, optimal time
to begin antiretroviral therapy (ART) and even the safe techniques of breast
feeding for HIV- vulnerable infants.
New improvised recommendations were summarized in
2010 in:Use of
antiretroviral drugs for treating pregnant women and preventing HIV infection
Some of the key recommendations were:-
1. Early recommendation of ART for pregnant females with CD4 cell counts
of ≤350 cells/mm3 or who
have stage III/IV HIV disease. HIV
drugs are also recommended for women who do not require them for their own
health but taking these drugs could reduce transmission.
2. Availability of patient -friendly
antiretroviral drugs as well as increase in the number of drugs available for
treatment in this group.
3. Usage of ARVs by breast feeding mothers and infants to prevent the
further spread of HIV transmission.
Longer duration of treatment in infants is also recommended.
An explicit detailed version with scientific
evidences favoring the recommendations is mentioned in the full guidelines
while a list of key or prominent recommendations is given in The Rapid
The vital information for the adaptation of WHO
recommendations is also mentioned in the detailed guidelines.
The guidelines of 2010 chiefly aim at low- and
middle- income segments and target to provide efficient interventions for the
reduction of MTCT in a resource-constraint environment.
In breast feeding mothers, MTCT is expected to
decline from 35% to 5%( or even lower) and in non-breast feeding mothers from a
background threat of 25% to even less than 2%, with the practical introduction
of these recommendations.
There is a strong compliance between the WHO 2010
guidelines and the newly recognized WHO guidelines development process. It
involves an apt reviewing of the consideration of practicability of the program
and the expected implications of the cost pertaining to the application of
these recommendations as well as the review of new evidences.
Both the adult ART and HIV and infant feeding
guidelines have been updated and revised in a synchronized manner by the WHO.