PMTCT

This week Siyayinqoba Beat It! again examines PMTCT, or prevention of mother to child transmission, programme as the impact of the recent protocol changes is beginning to emerge. The new protocols for the treatment and prevention of HIV require all pregnant HIV positive mothers to be able to access a programme to protect their babies from 14 weeks instead of 28 weeks. We visit two young mothers who were able to protect their babies because of the treatment made available to them.

Nomsa Sigauke from Daantjie in Nelspruit discovered her HIV status when she fell pregnant and visited the clinic for a check-up. She was invited to test and did so. Her results revealed she was HIV positive, with a CD4 count of 166. She was placed on a triple therapy treatment programme - meaning she was given Stavudine, Lamivudine and Nevirapine for herself as well as Nevirapine for her baby. Babies take the Nevirapine syrup after birth and continue for six weeks if the mother formula feeds, or for as long as she breast feeds. At six weeks a PCR test is given to the baby to check for HIV.

Nomsa's baby tested negative after six weeks and again after 18 months. Nomsa advises other mothers to visit the clinic and follow the right procedure so their babies will be HIV negative. Dr Trevor Majoro believes the new PMTCT programme has been "excellent." It means that if a mother's CD4 count is less than 350 she qualifies for treatment as early as the 14th week and she will be able to access Highly Active Antiretroviral Therapy (HAART). Nomsa will stay on her triple therapy treatment regimen for the rest of her life, however mothers who have a CD4 count of 350 and above take a short course of ARVs during pregnancy but they will only start full treatment when they need it.

Palisa Ngubane from KwaMaphumulo was placed on short course therapy because her CD4 count was above 350. Our CJs first met Palisa during her pregnancy and followed her story for several months until after the birth of her child. She was given AZT to protect her unborn baby, which she took twice a day. When we met with Palisa after the birth we learned that amidst the confusion she had forgotten to take her Nevirapine when in labour. Dr Majoro says this is a natural and understandable consequence of the confusion, especially for young mothers, and is more reason to better prepare and educate young mothers before the birth.

Palisa's baby was given Nevirapine and she took her child for a PCR test six weeks after the birth. She then had to wait another four weeks for the results. Fortunately the news was good and Palisa learned that her baby was HIV negative. The Gauteng Health Department recently announced that nine out of ten babies in the province born to HIV positive mothers do not have the virus. In Gauteng at least the programme seems to be having a real impact - the challenge is to extend these results across the country.