Maternal to child transmission of HIV is an entirely preventable event. HIV testing of pregnant women and treatment for those who are infected has resulted in a dramatic decline in the number of children perinatally infected with HIV. Still, perinatal transmission occurs with about 100-200 infants in the United States and 2-5 infants in North Carolina infected annually. Many of these infections involve women who were not tested early enough in pregnancy or did not receive adequate anti-retroviral therapy.
In November 2007, North Carolina implemented a rule change requiring HIV testing be offered to every pregnant woman at her first prenatal visit and in the third trimester. If a woman presents in labor with no record of an HIV test results, a rapid HIV testing must be performed. Antiretroviral therapy administered to the mother during pregnancy, labor and delivery, and then to the newborn, as well as elective cesarean section for women with high viral loads (more than 1,000 copies/ml), can reduce the rate of perinatal HIV transmission to 2% or less. If medications are started during labor and delivery, the rate of perinatal transmission can still be decreased to less than 10%.
Our goal is to reduce MTC transmission of HIV to zero cases each year and to identify any and all HIV infected infants as soon as possible in order to ensure appropriate management and care. North Carolina HIV/STD Prevention, in partnership with the Retrovirology Core Laboratory at the University of North Carolina at Chapel Hill, will offer HIV screening of infants who might be infected with human immunodeficiency virus type 1 (HIV -1). All infant specimens being tested for the presence of HIV by DNA PCR should be drawn and shipped according to the guidelines and forms posted below.
This program is anticipated to run from Jan 1st, 2010 through Sep 30th, 2010 with all testing free of charge during this time. Sites however must cover the cost of the shipping of the samples to the laboratory. Consultation regarding management of HIV in pregnant women is offered through Kristine Patterson, MD, in the UNC Division of Infectious Diseases. Dr. Patterson may be reached at (919) 966-2536.