A researcher from the UPV/EHU-University of the Basque Country has mapped the incredible decline in HIV infections transmitted from mother to child.

Miren Apilánez studied the development of pediatric HIV infection in Gipuzkoa, an autonomous community in northern Spain, from 1984 to 2011. In all, Apilánez studied 239 children born between 1984 and 2010 and their HIV-infected mothers. Thirty of these children were born with HIV and the other 209 showed clinical signs of the disease within the first few months of life.

The main features of pediatric HIV infection have changed since the mid-1980s: transmission rates, diagnosis and treatment methods, and the ways in which women become infected have evolved over the decades. Apilánez identified four distinct periods of evolution of pediatric HIV infection in Gipuzkoa. She used diagnosis and treatment methods as a way of defining each period.

The first period started with the diagnosis of the first child in 1984. This period, deemed by Apilánez as the ‘period of few resources,’ continued for a decade.

The second period began in March of 1994 when the world adopted a new standard of care for children with HIV called the ACTG076 protocol. Medical professionals named this guideline after the clinical trial that showed that administering a certain drug during pregnancy and delivery significantly reduced the transmission of HIV from mother to child, known as vertical transmission. Within three years of the start of the second period, vertical transmission rates plummeted from 25 percent to 8 percent.

Vertical transmission continued mainly in those women who did not know they were infected. The third period began in 1997 when medical leaders in Gipuzkoa suggested HIV testing for pregnant women to rule out infection. Doctors would start pregnant women on the antiretroviral drug, known as AZT, to reduce the risk for vertical transmission.

The fourth phase begins in March 2000 when the Professional Associations of Doctors and Nurses in Gipuzkoa worked to establish and enact guidelines for the early detection and treatment of HIV infection during pregnancy. By this time, advances in diagnostics and treatments made it possible to detect infection in all pregnant women and provide effective treatments including AZT and other antiretroviral drugs.

By the year 2011, the vertical transmission rate of HIV infection among pregnant women in Gipuzkoa fell from a high of 23.9 percent in 1984 to 2.4 percent in 2011.

Source: Apilánez, Miren. "Mother-to-child HIV Transmission in Gipuzkoa Has Fallen from 25% to 2% over the Last 25 Years." Basque Research. N.p., 29 Nov. 2013. Web. 11 Dec. 2013.