HIV Transmission from Mother to Child

Tragically, every year children are born with HIV or acquire HIV shortly after birth due to medical malpractice.

In many cases, the mother does not know during the pregnancy that she is HIV positive. Yet, the mother’s history can include factors that make the transmission of HIV to her child likely. In some cases, the mother has symptoms of HIV that are undiagnosed and untreated by doctors and nurses during prenatal care and delivery. In other cases, the doctors and nurses actually know that the mother is HIV positive, but do not provide proper treatment to prevent transmission to the child.

What Is HIV

HIV, also known as The Human Immunodeficiency Virus, causes AIDS by attacking the immune system and leaving the body vulnerable to a variety of life-threatening illnesses and cancers. Common bacteria, yeast, parasites, and viruses that ordinarily do not cause serious disease in people with fully functional immune systems can cause fatal illnesses in people with AIDS.

People who become infected with HIV may have no symptoms for up to ten years, but they can still transmit the infection to others. Meanwhile, their immune system gradually weakens until they are diagnosed with AIDS. Acute HIV infection progresses over time to asymptomatic HIV infection, then to early symptomatic HIV infection and later, to AIDS (very advanced HIV infection). Most individuals infected with HIV will progress to AIDS if not treated. However, there is a very small subset of patients who develop AIDS very slowly or never at all. These patients are called non-progressors.

HIV Transmission from Mother to Child

It is possible for an HIV-infected mother to pass the virus directly to her child before or during birth (known as “perinatal” transmission), or through breast milk. Approximately 20% of babies born to HIV-positive women who are not treated with transmission-reduction measures will be infected with HIV virus.

The breast milk of an HIV-infected mother contains the HIV virus, and while small amounts of breast milk do not pose significant threat of infection to adults, it is a viable means of transmission to infants. Approximately 5% of vertical transmission occurs via breast milk.

Prevention of HIV Transmission from Mother to Child

The first step in preventing the transmission of HIV from mother to child is to recognize that the mother is HIV infected. A pregnant woman may exhibit symptoms of HIV infection which should then result in treatment to prevent transmission of the virus to her child. Some of the early symptoms of HIV infection and AIDS that a pregnant woman may exhibit can include:

  • Herpes Simplex Virus – causing ulcers in the mouth or genitals
  • Tuberculosis – infection by the tuberculosis bacteria that predominately affects the lungs
  • Oral or vaginal thrush – yeast infection of the mouth or genitals
  • Herpes zoster – ulcers over a discrete patch of skin caused by this virus
  • Non-Hodgkins Lymphoma – cancer of the lymph glands

If a woman who is pregnant demonstrates symptoms of the HIV virus, appropriate treatment should be provided before and during birth, and the mother should be advised not to breast feed her child. By administering AZT during the later stages of pregnancy and delivery, the probability that the HIV virus will be transmitted to the child is reduced to 5% – 8%. By performing a caesarian section (c-section) during delivery in addition to AZT therapy, transmission can be reduced to less than 2%. Because it is possible for the mother to transmit the HIV virus after delivery through breast milk, doctors and nurses should also advise the mother not to breast feed her child. Studies are currently being conducted to determine whether vaginal cleansing and the use of antiviral vaginal suppositories prior to birth may also be effective in reducing mother-to-child, or “perinatal,” transmission.

Treatment For Children with HIV infection

Combination antiretroviral therapy with such drugs as zidovudine and didanosine, zidovudine and lamivudine, or didanosine and stavudine with protease inhibitor-containing triple combinations, can significantly provide both immunologic and virologic benefits. Such combination therapies confer significant survival benefits in infected children.

Children should be followed with blood work frequently after beginning antiretroviral therapy. Complications of antiretroviral therapy in children include myopathy, pancreatitis, dyslipidemia, insulin resistance, glucose intolerance, changes in body shape, and lactic acidosis. Routine clinical monitoring should thus include liver enzymes, and a complete blood count for glucose, electrolytes and anion gap, total cholesterol, and triglycerides.

Vaccinations should include Haemophilus influenzae and pneumococcal conjugate vaccines as encapsulated bacteria cause considerable morbidity for HIV-infected children. Pneumococcal conjugate vaccine is recommended for children 2 to 5 years of age who have not already received it, followed by 23-valent pneumococcal polysaccharide vaccine. Varicella vaccine, a live virus vaccine, can be considered for HIV-infected children without immunosuppression. Measles, mumps and the rubella vaccine can be safely given to HIV-infected children who do not have severe immunosuppression.

Life Expectancy For Children with HIV infection

The course of HIV and the life expectancy of a child with HIV can vary greatly. There are two major groups of children with HIV. One group consists of rapid progressors, who develop symptoms early in life, develop serious complications and AIDS early and often die before the age of five. The other group consists of long term survivors, who generally develop symptoms much later (some not until their early teens) and live longer. Generally, children with perinatal infection do not survive beyond their early 20’s. The median survival age is 8 to 9 years.

If Your Child Has HIV

If your child suffers from HIV as a result of medical malpractice, you should contact a competent lawyer immediately. The lawyer will be able to work with you to determine whether there were signs that HIV could be transmitted to your child and whether your doctors should have provided treatment.