Important note: Information in this article was accurate in 1997. The state of the art may have changed since the publication date.
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The San Francisco Examiner - Tuesday, Dec. 2, 1997
Venise Wagner of the Examiner Staff
While 26 to 30 percent of HIV-positive mothers are likely to transmit the disease to their infants, giving pregnant women protease inhibitors in combination with other drugs can bring that number down to as low as 4.6 percent, Dr. Diane Wara, UC-San Francisco professor of pediatrics, said Monday.
Primarily as a result of the therapy, not one of the 56 HIV-positive mothers who have delivered since April 1995 at UCSF's Bay Area Perinatal AIDS Center at San Francisco General Hospital has passed on the virus to her newborn.
"Our ultimate goal used to be to prevent transmission from mother to child," said Dr. Karen Beckerman, the program's director. "Now our ultimate goal is to get the mom to her child's high school graduation. We still don't know if we can do that."
The Perinatal AIDS Center's program, which began in 1987, routinely offered AZT to HIV-positive pregnant women to reduce their chances of transmitting the virus. But in 1996, as studies began showing the remarkable response to combination therapy for many adults, physicians at BAPAC decided to use it on their patients.
But Wara and Beckerman temper their optimism.
"We have not achieved (this decrease in transmission) throughout the country," said Wara. "In pockets of New York City, it is still 25 percent."
For the children who do get AIDS, said Wara, the factors determining their health are not only access to the drugs but also parents' effectiveness in administering treatment to their children.
Of the 8,000 children in the United States with AIDS, most come from disadvantaged homes, and more than 60 percent are black, Wara said, though black children make up 15 percent of the population. Many don't have a single clinic or physician to treat them, nor are they consistently monitored, she said. And often their economic and social circumstances make it difficult for them to keep up with the demanding regimen of medication.
"There are levels of complication," Wara said. "If you go to Fresno, to the migrant farm camps, you've got people who are constantly in transition. Add in language (barriers), that makes it very difficult."
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