Sunday, January 30, 2005

Beating HIV in Babies

Years and years ago I staffed an HIV clinic in Louisiana filling prescriptions. Back then, our understanding of HIV and how to fight it was still in its infancy. Working in the hospital, I also remember working up the first physicians' order for an intravenous infusion of AZT for the Labor and Delivery floor. The strategy that I played a very small role in implementing was a miracle in the making.
In 1990, as many as 2,000 babies were born infected with H.I.V., the virus that causes AIDS; now, that number has been reduced to a bit more than 200 a year, according to health officials. In New York City, the center of the epidemic, there were 321 newborns infected with H.I.V. in 1990, the year the virus peaked among newborns in the city. In 2003, five babies were born with the virus.

Across the country, mother-to-child transmission of H.I.V. has dropped so sharply that public health officials now talk about wiping it out.

But these facts I find outrageously mystifying:
The stigma of AIDS posed a significant barrier to the flow of vital information. While the state started an AIDS surveillance program in 1981 and tested all newborns for H.I.V. beginning in 1988, for years the program was conducted blind, meaning that no names were attached to the data. If a mother gave birth to a sick child, she would not be told that she or the child had H.I.V. Often the mother would not learn that both had the infection until the baby showed serious, usually fatal symptoms. And health workers did not track down and notify sexual partners of those who had the disease, a standard practice with other sexually transmitted diseases.(/snip)

Dr. Guthrie S. Birkhead, director of the AIDS Institute and the Center for Community Health at the New York State Department of Health, said that in 1997 the state finally began attaching patient information to the newborn H.I.V. tests it conducted and then passing that information along to a patient's doctor, so that mothers could get treatment.

In 1998, a state law was passed that required hospitals to conduct immediate testing of newborns. The results could be learned in 12 hours, and patients could be treated promptly.

"The newborn testing became a safety net," Dr. Birkhead said.

Although New York was hit harder by AIDS than any other state, New York lagged when it came to AIDS reporting, said Dr. Torian, of the city's health department.

"It is very hard for us to understand at this point," Dr. Torian said. "It felt from the public health point of view, and even from the personal view of the mother, not to be a rational stance."

In the last four years, only one baby has been born with H.I.V. at Harlem Hospital Center. Gone are the days when every bed in an orphanage created to take in children born with H.I.V. was filled as quickly as it became available.(emphasis mine)
It took until 1997 to do what should've been going on since the disease was first described. This is nothing short of criminal. Matter of fact, probably just as criminal as the French's behavior with the HIV virus and their country's blood supply.