Bangladeshi scientists have claimed to have achieved an extraordinary feat by successfully treating over 100 pregnant mothers sick with the fatal HIV (human immunodeficiency virus), but they gave birth to healthy babies, saying the success rate was more than 98 percent.
“HIV positive mothers numbering 109 were treated under the PMTCT programme. Among them, 107 HIV positive mothers gave birth to healthy babies free from HIV, while two were born with HIV positive as the pregnant mothers came late for the treatment,” Prof Dr. Md. Shamiul Islam, Line Director of AIDS/STD Programme (ASP), told the daily sun.The health directorate official claimed that Bangladesh has achieved more than 98 percent success in giving birth to safe baby by the HIV positive mothers while the global success rate is around 72 percent to 78 percent.
The Bangladesh government is providing treatment free of cost for the HIV positive mothers under the programme titled ‘Prevention of Mother-To-Child Transmission (PMTCT)’ which is being implemented by AIDS/ STD Programme (ASP) of Directorate General of Health Services (DGHS) with the support of UNICEF (United Nations Children’s Fund).
Islam said PMTCT centers have been set up in Bangabandhu Sheikh Mujib Medical University (BSMMU), Khulna Medical College, Sir Salimullah Medical College and Mitford Hospital, Sylhet MAG Osmani Medical College, Chattragram Medical College and Cox’s Bazar Medical College,” adding that the treatment was being extended to Infectious Diseases Hospital in Dhaka, Jashore Medical College and Moulvibazar Hospital to provide health care for the HIV positive mothers.
At the same time, the government also has set up 12 ART (Anti Retroviral Therapy) centers in hospitals across the country to provide the counseling and antiretroviral (ARV) drugs for the HIV/AIDS (Acquired Immuno Deficiency Syndrome (AIDS) positive people of the country, the DGHS director said.
Shamiul Islam said there are around 13,000 estimated HIV or AIDS positive patients in Bangladesh till November 30 while 7,544 HIV positive people have already been diagnosed and among them 4,600 are taking treatment services under the ART centers across the country.
“I’m happy as my son is seven years now and he is studying in a local school. My son is free from HIV or AIDS. Earlier, I couldn’t believe that I could give birth to a safe child free from the HIV or AIDS as me and my husband both are HIV/AIDS positive,” said Farida (pseudonym), one of the first mothers to give birth to a healthy child after being treated at the PMTCT center in BSMMU.She told the daily sun she got HIV from her husband who worked in a Middle-Eastern country. “He has been taking ARV at the ART center of the BSMMU,” she said.
“The PMTCT center was set up at the BSMMU in 2013 and the first HIV positive mother gave birth to a healthy child at the BSMMU the same year, which was a matter of great joy for us,” Dr. Marina Akhtar, Programe Manager of Strengthening of HIV Services in BSMMU told the daily sun.
Speaking about the process, she said many women went for ANC (Antenatal check up) at the PMTCT center of the BSMMU regularly from May 2013. “Among the diagnosed mothers, 91 pregnant women who were HIV positive were treated under the PMTCT center at the hospital during the time.”
“Of the total, 75 HIV positive mothers gave birth to safe babies meaning the children do not have AIDS. It was confirmed that they were clean only after the DNA Polymer Chain Reaction test, in the BSMMU. Some other HIV positive pregnant mothers are waiting for delivery to give birth to child. Now the pregnant mothers have been taking ARV at the ART center of the hospital regularly,” Merina added.
Talking to daily sun about the activities of the PMTCT, Tanzina Rahman, Counselor cum Tester at PMTCT center of the BSMMU said once a HIV positive mother comes to the center she is taken immediately under the antiretroviral therapy that suppresses HIV at the ART center. “The PMTCT center provides both indoor and outdoor services for the HIV positive mothers and would be mothers,” she added.
The pregnant mothers were also given necessary counseling about pregnancy and how to give birth to a healthy baby, Tanzina Rahman said.
Prof Dr Saleha Begum Chowdhury, former chairman of Obstetrics and Gynaecology department of the BSMMU, said after birth, babies, whose parents have AIDS, were first given a health check to detect whether the baby was HIV positive or negative. “Then the baby is given Nevirapine syrup, also a suppressive drug, for six weeks.”
She said at the age of 42 days, the baby will be taken under first PCR (DNA Polymer Chain Reaction) blood test to know whether the infant is free from HIV or not. “If the baby is negative then ARV profile excess will be stopped after 42 days. If the mother feeds the baby breast milk then babies are given co-trimoxazole from the 43rd days of age that will continued till thirteen and half months old while dozes will be determined on the basis of age of the baby,” she added.
Saleha Begum Chowdhury said when the baby is at the age of one year then breast milk feeding will have to be stopped for six weeks and later after six weeks of stopping the breast milk, the baby will be taken under second PCR blood test. “If the second PCR is negative then HIV antibody will have to be tested at the age of 18 months old to confirm whether the baby is free from HIV or not,” she added.
After all, a baby goes through the test twice — at six weeks old and at thirteen and a half month old, confirming that the baby is free of HIV, she said, adding that “if the babies are found HIV positive even after 18 months old then the children also will be taken under lifelong treatment process.”
Prof. Saleha Begum Chowdhury, also Secretary General of Obstetrical and Gynaecological Society of Bangladesh (OGSB) said in Bangladesh, mothers with HIV were not forbidden to breastfeed their babies.
“We allow them to feed their babies breast milk, considering their economic condition and hygiene issue to prevent diseases like pneumonia infection and diarrhea infection. In many parts of the world HIV positive mothers are not allowed to do so as there is a risk of transmission,” she said.
Describing estimated risk and timing of Mother-to-child transmission of HIV, Prof Dr. Saif Ullah Munshi, Chairman of Department of Virology of the BSMMU said in the absence of interventions, around a third of HIV positive mothers will pass the virus to their infants through one of these three routes — during pregnancy and labor, during delivery and post partum through breastfeeding.
Dr. Md. Ziya Uddin, HIV/AIDS Specialist of UNICEF Bangladesh said 62,000 pregnant women received HIV tests, while 48 HIV positive pregnant women were enrolled in the PMTCT centers in Bangladesh till November 30 this year. “Some 13 infants were declared HIV free at the age of 18 months after anti-body testing this year,” he added.
“During the last five years, there were trends of more infections among migrant populations and women, although they were not from the high risk populations. These were reflected in identification of positive pregnant women. To save new infections among the newborn and infants, it is important to expand and integrate PMTCT along with MNCH in Bangladesh,” he added.
According to the UNICEF, elimination of new HIV infections among children can be achieved through the Prevention of Mother To Child Transmission (PMTCT). PMTCT is an intervention to ensure that no child is born with HIV and it is an essential step to ensuring an AIDS free generation.
According to the World Health Organisation (WHO) in the absence of any intervention, mother to child transmission of HIV rate ranges from 15 percent to 34 percent and this rate can be reduced to below 5 percent with effective interventions during the periods of pregnancy, labour, delivery and breastfeeding.
It said new Sustainable Development Goals place heightened emphasis on prevention of mother-to-child transmission (PMTCT) in the context of better health for mothers and their children.