All pregnant women who are HIV positive will get free Antiretroviral Therapy (ART) till the time they breastfeed the child, the government has decided. The scheme will roll out next year with the new National Aids Control Programme (NACP IV), officials said.
Currently, the state provides preventive medication to HIV positive women during childbirth and to the newborn. Experts said this is a significant decision that will reduce the mother-to-child transmission to 2% as opposed to 15% to 20% now.
Ramesh Devkar, project director of the Maharashtra State AIDS Control Society (MSACS), confirmed the move. "This programme could almost eliminate mother-to-child transmission," said Dr Mamata Manglani, head of paediatric ART centre at Sion hospital.
The existing programme involves administering nevirapine (a drug that reduces the chance of HIV transmission to the child) to the woman during labour and to the newborn within 72 hours of birth. As of now, the pregnant woman is given ART only if her CD4 count - which indicates the immunity level - is less than 250.
The mother-to-child transmission can happen at three stages: during pregnancy, childbirth and breastfeeding. "With nevirapine, only 10% to 15% of the children will get infected. But if the programme includes pregnancy and breastfeeding, we can reduce transmission to 2%," said Dr Manglani. The new early infant diagnosis programme, which includes finger-prick blood test at six weeks and two repeat tests, have confirmed HIV in 152 babies in the state since April 2010. The children are given ART irrespective of their CD4 count till the age of two.
The MSACS has also fanned out its operations to provide ART to children at all its ART centres in the state. "Parents would have to travel 1,000 km to get ART for their child every month, which was not feasible. Earlier only 20 children were getting AR, now it's 210 across the state," said Devkar.