Doctors mark 15 years without an HIV-infected newborn
Yale Medical Group clinicians who treat young patients who are HIV-positive are wrapping up the year on a celebratory note: It’s been 15 years since an HIV-infected baby was born at Yale-New Haven Hospital. The last one is now a teenage boy who is living a healthy life and doing well in school.
Credit for this success goes to aggressive screening of pregnant women and newborns, and treatment of women who are HIV-positive. Warren Andiman, MD, medical director of the Yale Pediatric AIDS Care Program, spoke about the approach in a story and videotaped interview with the New Haven Register.
In the mid-1980s, when the Yale Pediatric AIDS Care Program began caring for HIV-infected children, young patients died painful and protracted deaths, often before they celebrated their 10th birthdays. “There’s no way to describe what it was like,” says Dr. Andiman.
Since that time, the Pediatric AIDS Care Program has cared for every baby born to an HIV-infected mother in Greater New Haven, or about 500 babies. During the first decade, about 20 percent of those babies were infected with HIV themselves. That number dropped to zero in 1996 and stopped going up as the program became more effective in diagnosing, treating and monitoring pediatric AIDS patients.
“We literally put ourselves out of work,” Dr. Andiman says, quickly adding that this has been “crowning achievement of my career.”
Connecticut law mandates that all obstetricians offer HIV testing to all women twice during pregnancy and document the results in their medical records. Any pregnant woman in New Haven who tests positive is referred to Yale’s High-Risk Maternity Program or a parallel program at the Hospital of St. Raphael.
Both programs work with the Yale Pediatric AIDS Care Program to protect the fetus from contracting the virus. The mother is given antiretroviral drugs during her pregnancy and delivery. Caesarean deliveries and avoiding breastfeeding can also reduce mother-to-child transmission. All exposed babies are treated for the first weeks of life, after which doctors can tell if they have been infected.
Only one or two pregnant women have refused testing in the past 15 years, Dr. Andiman says, adding that most mothers will put their baby first. “Even mothers who don’t care enough about their own health will do whatever they can to protect the baby.”
To contact the Yale Pediatric AIDS Care Clinic, please call 203-688-6093.