A program in Baltimore for pregnant women infected with the virus that causes AIDS has proved 98 percent successful in preventing transmission of the disease to newborn babies, the city's health commissioner announced yesterday.
Only one of the 48 babies born to infected mothers enrolled in the University of Maryland Hospital's Pediatric AIDS Program during the past two years has tested positive for the HIV virus, Dr. Peter L. Beilenson said at a news conference.
"Ten to 15 years ago, there was a view that mothers with HIV would give birth to a whole generation of babies with HIV," Beilenson said. "But today, mothers with HIV are delivering noninfected children. This is very good news."
As part of a $1 million-a-year, federally funded program, mothers receive a triple-drug regimen that slows the spread of the virus and prevents it from being passed to their babies.
Before mothers started taking the Highly Active Anti-retroviral Therapy (or HAART drugs), they would pass the virus on to their children about 25 percent of the time.
Based on that pattern, about 12 of the 48 women in the University of Maryland program would have been expected to give birth to HIV-infected babies.
But with the drug therapy and support by social workers who encouraged the women to keep on their medication schedule, only one of them had an infected baby.
"With good comprehensive care, transmission from mothers to their babies can be reduced to close to zero," said Vicki Tepper, director of the Pediatric AIDS Program at the University of Maryland.
Johns Hopkins Hospital, Mercy Medical Center and other hospitals in the city offer similar programs that have also proved successful, said Beilenson.
Together, these programs have reduced the likelihood that an HIV-infected woman will give birth to an infected baby to about 10 percent.
Doctors, working under a state law that requires hospitals to offer HIV tests to pregnant women, discovered that about 90 women in the city were both infected with the virus and expecting children last year. Nine of these women gave birth to infected babies, Beilenson said.
"There has been a dramatic decrease in the number of HIV-infected babies delivered," said Dr. John Farley, chief of pediatric immunology at the University of Maryland Hospital.
The three-drug regimen is expensive, costing as much as $12,000 a year, and it requires discipline from the patients, who must take as many as 15 pills a day.
The Pediatric AIDS Program provides counseling to help women keep this difficult schedule and follow through with regular doctor visits. It even provides cab fare for women who find it hard to get to the hospital.
Because many of the women have little money, they qualify for a federal insurance program that pays for their treatment.
The program at the University of Maryland is 15 years old and employs 25 doctors, social workers and others. It has seen gradual improvement in the rate of transmission from mothers to their babies during the past decade, with a dramatic improvement in the last two years, according to administrators.