Risk of HIV transmission from mother to child

risk of mother-to-child transmission in HIV

In untreated women:

• risk of mother-to-child transmission (MTCT) of HIV is between 15% and 20% in non-breastfeeding women in Europe and between 25% and 40% in breastfeeding African populations
  
  
• in the absence of breastfeeding, it is estimated that over 80% of transmissions occur perinatally, around the time of labour and delivery
  
  
• risk of transmission is determined by
  • maternal health
  • infant feeding
  • obstetric factors
    • mode of delivery
    • duration of membrane rupture
    • delivery before 32 weeks of gestation
      
      
• sexually transmitted infections and chorioamnionitis have also been associated with perinatal HIV transmission in some studies
  
  
• breastfeeding doubles the risk of mother-to-child transmission from around 14% to 28% (1).

In treated women:

• in resource-rich countries, effective HAART(highly active anti-retroviral therapy -a combination of three or more anti-retroviral drugs), appropriate management of delivery and avoidance of breastfeeding have resulted in transmission rates of less than 2%
• two cohort studies carried out among women who were HIV positive and taking HAART who had a plasma viral load of less than 50 copies/ml at delivery have revealed that:
  • in the UK/Irish cohort - out of 2117 infants born, three babies were infected (0.1%)
  • in the French cohort - in 1338 women who were HIV positive and delivered at term,five babies were infected (0.4%) (1).

Reference:

• (1) Royal College of Obstetricians and Gynaecologists (RCOG) 2010. HIV in Pregnancy, Management (Green-top Guideline No. 39)