Brussels, 20 June 2002
New guidelines aimed at reducing mother-to-child transmission of HIV are emerging from European research. The guidelines for the treatment of various groups of HIV-positive patients are to be published on 28 June 2002.
A comparable set of guidelines for paediatric patients will be published in July 2002. A consortium of 15 research teams from 7 European countries, has worked together to produce the set of guidelines for best practice. Their report highlights that certain precautions and the appropriate use of anti-retroviral therapy during pregnancy, labour and in the neonatal period can reduce the risk of mother to child HIV transmission (MTCT) from 15-20% (without intervention) to less than 2%.
Mothers should undergo HIV testing, caesarean section, anti-retroviral therapy, and avoid breast-feeding. Children should undergo anti-retroviral testing after birth. "The definition of HIV treatment guidelines that will limit the risk of mother-to-child transmission of the virus is a good example of the benefits of research co-operation at EU level", said EU Research Commissioner Philippe Busquin. "HIV knows no borders and we need to bring together the best specialists to stem the epidemic and find appropriate treatments."
World-wide, 40 million people are living with HIV/AIDS, of these 17.6 million are women. 5 million people were infected in 2001: 1.8 million women, 800,000 children under 15. 3 million people died of AIDS in 2001: 1.1 million women, 580,000 children under age15(1).
In Europe, 560,000 people are living with AIDS. The number of HIV infected adults continues to increase: 30,000 were infected in 2001 and 25% of those are women. The occurrence of HIV-positive pregnant women is a growing concern and MTCT is a critical issue.
Although strong and effective anti-retroviral therapy is now available to delay progression of the disease, this needs to be used with care and under certain circumstances. Commission guidelines:
recommend that all pregnant women (and if possible their partners) have a HIV test;
offer HIV-infected women the option of delivering their child through a caesarean section (before labour and rupture of membranes), as this has been shown to reduce risk of MTCT;
offer all HIV-infected women anti-retroviral therapy during pregnancy to reduce MTCT, with choice of therapy and timing depending on their clinical status; in fact a great deal of attention is given to the various factors influencing this choice, the possibilities for treatment and the need for informed consent of the patient;
recommend anti-retroviral therapy for the child immediately after birth;
strongly advise HIV-infected mothers against breastfeeding, as the risk of MTCT through breastfeeding is substantial and unnecessary as safe alternatives are available. The European Commission is strongly committed to combating AIDS in Europe, through the priority on "combating major diseases" defined in the next European research Framework programme (2002-2006). It is also tackling AIDS in Developing Countries, where it is linked with poverty, through the recently initiated European-Developing Countries Clinical Trials Programme (EDCTP) which proposes to contribute €200 million and trigger co-operation between European and African countries.
For more on the 6th Framework programme: http://europa.eu.int/comm/research/fp6/ index_en.html
For information on EDCTP: http://europa.eu.int/comm/research/edct p.html .
(1) Source: UNAIDS epidemic data (December 2001)
DN: IP/02/905 Date: 20/06/2002