Explain how HIV transmits from mother to child?

Mother-to-child transmission (MTCT) of HIV is a significant concern and can occur during pregnancy, childbirth, or breastfeeding. However, with proper interventions and medical care, the risk of transmission can be significantly reduced.

During pregnancy, HIV can be transmitted from an HIV-positive mother to her unborn child. The transmission may occur when the virus in the mother's blood crosses the placenta and infects the developing fetus. The risk of transmission during pregnancy is influenced by various factors, including the mother's viral load (the amount of HIV in her blood), the presence of other infections, and the stage of her HIV disease.

One key strategy to prevent mother-to-child transmission during pregnancy is the use of antiretroviral therapy (ART). ART consists of a combination of medications that target the HIV virus at different stages of its life cycle. When an HIV-positive pregnant woman takes ART as prescribed, it can reduce her viral load, thereby lowering the risk of transmitting the virus to the baby.

In addition to ART, another preventive measure is elective cesarean section (C-section) delivery. This method is recommended when the mother's viral load is high or if she is not effectively taking antiretroviral medications. Delivering the baby through C-section before the onset of labor and rupture of membranes helps reduce the risk of exposure to the virus during childbirth.

The most critical period for mother-to-child transmission is during labor and delivery. The baby can come into contact with the mother's blood and other bodily fluids during this process, creating a potential route for transmission. Antiretroviral medications are often administered intravenously during labor to further reduce the risk of transmission at this stage.

Breastfeeding is another potential route for HIV transmission from mother to child. HIV can be present in breast milk, and if the baby ingests infected milk, there is a risk of transmission. In regions where safe and affordable alternatives to breastfeeding are available, avoiding breastfeeding altogether may be recommended for HIV-positive mothers. However, in resource-limited settings where access to clean water and formula may be challenging, the World Health Organization recommends that HIV-positive mothers breastfeed exclusively for the first six months and then introduce appropriate complementary foods while continuing to breastfeed until 12 months of age. During this period, the mother is advised to take antiretroviral medications consistently to reduce the risk of transmission through breast milk.

To further decrease the risk of mother-to-child transmission through breastfeeding, some countries recommend the use of infant prophylaxis. This involves providing the baby with antiretroviral medications for a specified duration during the breastfeeding period.

It's important to note that advancements in medical interventions have significantly reduced the rates of mother-to-child transmission of HIV. With proper medical care, including antiretroviral therapy, close monitoring, and adherence to recommended interventions during pregnancy, childbirth, and breastfeeding, the risk of transmission can be minimized, allowing HIV-positive mothers to give birth to healthy, uninfected babies. Additionally, routine testing and early detection of HIV in pregnant women enable timely interventions to prevent transmission and ensure the well-being of both mother and child.