Experts hope to cut newborn AIDS rate But rise in infections in young women concerns authorities

December 02, 1997|By Jonathan Bor | Jonathan Bor,SUN STAFF

Advances in AIDS therapies have begun to spare many children from acquiring the deadly virus in the womb, but authorities expressed concern yesterday that a rising infection rate among women of childbearing age has thwarted progress.

As the nation observed World AIDS Day, doctors said they were encouraged by data showing that drug regimens have reduced the chance of passing the virus from mother to child from 25 percent to as low as 5 percent -- 5 out of every 100 children born to women receiving state-of-the-art care.

Experts, however, are hoping to lower the rate much further by giving pregnant women the same triple-drug "cocktails" that have prolonged the lives of adults living with AIDS. These cocktails include the widely heralded class of medications known as protease inhibitors.

Dr. Peter E. Vink, who directs the pediatric AIDS service at the University of Maryland Medical Center, said he could imagine rates as low as "1 to 2 percent" -- although the cocktails, of course, would have to prove themselves in a lengthy clinical trial.

Pending final approvals, the trial could begin as early as next month at numerous medical centers across the country -- including the UM Medical Center and Johns Hopkins Hospital.

Recent gains against pediatric infections have been made with aggressive use of the drug AZT, given to mothers during pregnancy and labor, and to their infants.

Vink noted, however, that other forces are converging to expose fetuses to the human immunodeficiency virus, which causes AIDS.

For one thing, women of childbearing years are becoming infected at a faster pace than any other risk group in the United States.

"It isn't over by any means," said Vink, who spoke during an observance of World AIDS Day in the lobby of the university hospital. In Maryland, well over half of the infected children were born to women who acquired the virus through intravenous drug use or through sexual contact with drug users.

Federal officials agreed that rising cases among women are limiting the nation's success in reducing the number of children who are born infected.

"Between 1991 and 1995, the number of women diagnosed with AIDS increased by more than 60 percent, more than any other group reported with AIDS regardless of race or mode of transmission," said Dr. Mary Lou Lindegren of the national Centers for Disease Control and Prevention.

Among those diagnosed was Sarah Chambers of Baltimore, who learned she had AIDS in 1991 and lost her 3-year-old son, Queenan, to the disease in 1995.

Recently, she went about the grim business of finding someone to take care of her older, uninfected son in the event she dies.

"It really scared me -- I felt hurt when I had to make the decision to pick someone to be his guardian," said Chambers, who leaned on a cane during the World AIDS Day observance. "Now, I feel wonderful about it. It's good to know that he'll be taken care of." She chose a family friend.

Chambers, who takes triple-drug therapy, wore a T-shirt carrying Queenan's silk-screened image and the dates of his short life: July 21, 1991 to June 30, 1995. Her older son, Joseph, who is 9, rested his head against her arm, tears rolling down his cheek as speakers recalled the lives lost to AIDS.

More than 7,500 children across the country have been diagnosed with AIDS since the disease surfaced in 1981. This number includes about 270 youngsters in Maryland -- about half of whom have died.

Protease inhibitors are being given to children with HIV infection and, in many cases, have begun to prolong their lives.

About 600,000 people in the United States -- most of them adults -- have been diagnosed with AIDS since the epidemic began.

"This is sobering when you think that it's more men and women than those who lost their lives defending their country since the First World War," said Dr. Robert Redfield, who heads clinical AIDS services at the UM Medical Center.

To take advantage of new therapies, Redfield said, it is "critical" for people to get diagnosed and enter treatment early in their infection. Only half of the 14,000 people living with HIV infection in Baltimore are receiving care.

Worldwide, more than 30 million people are infected with HIV. This includes 1 million children.

Most of the pediatric cases are in developing countries, where 300,000 children are born infected each year and where families cannot afford expensive treatments.

With today's therapies, protecting children against AIDS TC depends greatly upon the amount of treatment their mothers receive. In the best cases, where women actually plan their conceptions by improving their nutrition, getting off drugs and taking anti-viral drugs, the rate can be depressed to 5 percent, Vink said.

Across Baltimore, however, the overall transmission rate is about 10 percent. This higher figure takes into account pregnant women who begin AZT treatment when they are quite ill -- and women who receive little or no treatment before they deliver. At the university medical center, 80 percent of the infected mothers did not learn they had the virus until they were tested in a clinic where they sought prenatal care.

To learn more

For more information about topics covered in this article, go to The Sun's Web site, SunSpot, at

Pub Date: 12/02/97

Baltimore Sun Articles
Please note the green-lined linked article text has been applied commercially without any involvement from our newsroom editors, reporters or any other editorial staff.