ZIMBABWE has managed to reduce mother-to-child HIV transmission to 18 percent but researchers say elimination of breast-feeding can, among other things, help take the country to within the five percent risk levels recommended by the World Health Organisation (WHO).
According to an article in the January issue of medical journal PLoS Medicine, at least 16 percent of pregnant women in the country are infected with HIV and most mothers breastfeed their infants which is one means of viral transmission.
But the country has managed to reduce transmission risk levels through a three-drug antiretroviral therapy on pregnant women with advanced HIV infection and a single dose of the antiviral drug nevirapine for all others.
The programme reached more than half the country's HIV-infected pregnant women in 2009, reducing transmission rates to18 percent.
However, researchers have found that transmission risk could be decreased further to 14 percent with even greater participation among infected women and the use of newer medications.
“Mother-to-child transmission could be further reduced to 6 to 7 percent – approaching "virtual elimination" – if three goals can be reached,” the researchers noted in the PLoS Medicine article.
These goals include ensuring that 95 percent of infected pregnant women receive the most effective available medications as well as maintaining excellent medication adherence for both mothers and infants throughout pregnancy and breastfeeding.
The country would also need to ensure that breastfeeding is safely reduced or avoided altogether which requires access to both adequate infant formula and safe drinking water.
"Pediatric HIV infection has been nearly eliminated in resource-rich settings, such as the U.S. and Europe, through a combination of anti-HIV drugs and avoidance of breastfeeding," Andrea Ciaranello of the Massachusetts General Hospital (MGH) division of Infectious Diseases and lead author of the PLOS Medicine report said.
"The WHO has urged health programmes throughout the world to aim for the same successes, calling for the 'virtual elimination' – defined as reducing transmission risk to less than 5 percent – of mother-to-child HIV transmission.”
The researchers however concede that maintaining this "cascade of care" can be particularly challenging in resource-poor areas like sub-Saharan Africa, where as much as 90 percent of worldwide mother-to-child transmission takes place.