Pregnancy and HIV Infection

What is HIV?

HIV, the human immunodeficiency virus, is the virus which causes AIDS. The virus attacks one particular type of cells in the body, called T-helper lymphocytes. These cells are important as they help to co-ordinate the body's immune system. Over time HIV damages the immune system so badly that it can no longer fight infection and cancer as it would usually do. Most people who are infected with HIV have long periods when they look and feel quite well. Many people do not even know that they are infected.


What is AIDS?

A person is said to have AIDS (Acquired Immunodeficiency Syndrome) when their immune system is so weak that they develop certain serious illnesses. The average time between the infection with HIV and the development of AIDS is 8-10 years in men and it is suspected to be the same in women. An estimated 10-20% of people infected with HIV have AIDS.


How can People Become Infected with HIV?

HIV is present in the vaginal fluids, semen, blood and breast milk of infected people. HIV can be passed from one person to another when infected vaginal fluid, semen, blood or breast milk gets into another person's body. An infected woman can also pass the virus onto her baby in the womb or during birth.
Most people with HIV became infected by having sexual intercourse without a condom with somebody who has HIV. In Britain and Ireland, 59% of women infected with HIV acquired the infection through heterosexual intercourse, 37% of women infected with HIV acquired the infection through sharing needles and syringes and 3% of women infected with HIV acquired the infection through having been transfused with infected blood or blood products. In the UK all donated blood has been tested for HIV since 1985 and is now considered extremely safe.


HIV Testing as Part of Your Antenatal Care

When a pregnant woman comes for antenatal care, a sample of blood is usually given in early pregnancy. Just one sample can be used for a number of tests. However pregnant women are not automatically tested for HIV in the UK. In some antenatal clinics the test is offered but in most, women have to ask for it. In other parts of the world, though, HIV testing is madatory in early pregnancy.


Does Pregnancy Itself Make the HIV Infection Worse?

Pregnancy itself does not make the HIV infection worse. In addition babies born to mothers with HIV do not have an increased chance of suffering complications in pregnancy and labour as compared to babies born to HIV negative mothers.


Should I Have the Test if Offered?

Testing of mothers will only be done if verbal consent has been given and it is the job of the health professionals offering the test in the antenatal clinic to make you aware of the advantages and disadvantages of knowing your HIV status.
In summary, the main advantages to the pregnant woman of knowing she is HIV positive are that drugs can be given in pregnancy and to the baby after delivery to reduce the chance of the baby being infected. Caesarean section can be planned which also reduces the risk of infection and you can choose to bottle feed instead of breast feed, as the virus may be transmitted in breast milk.


How Big is the Problem in the UK?

In 1998, there were over 200 births to HIV infected women in London, the highest number ever. This is estimated to have led to about 35 infections in babies in London alone. Elsewhere in the UK there were around 100 births to HIV infected women leading to about 25 infections in babies.