Crypto News: Halting HIV Transmission During Pregnancy

Hi, it's Janice in Johannesburg. The global fallout from the coronavirus pandemic has jeopardized gains in many other areas of health care. Women's health and childhood well-being are no exception. But first...

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In the search for an HIV vaccine, a shot has been trialed that almost erases the chances of contracting the virus through sex. Getting it tested in pregnant and breastfeeding woman is the next hurdle.

As the world commemorated World AIDS Day this week and took stock of how the Covid-19 pandemic has weakened Africa's already-stretched health services, finding a way to offer exactly this group of woman an anti-HIV injection is key to reducing spread of the virus that causes the auto-immune disease AIDS.

Those newly infected with HIV initially have a surge of the virus, increasing the likelihood of transmission, according to Linda-Gail Bekker, chief operating officer of the Desmond Tutu HIV Foundation. In South Africa, there are enormous numbers of babies being born with HIV, she said in an interview.

With the world's biggest number of children infected with HIV — more than 310,000 — the country could be just the place to start research on pregnant woman. Mother-to-child infection raises the risk of children dying. Those that survive will need lifelong treatment with anti-retroviral drugs, otherwise the disease is fatal.

"It would be amazing is if we could offer it to pregnant woman so that we prevent new infections," Bekker said. "The country has a lot of work to do in stopping mother-to-child infection."

At the moment, one of the biggest issues preventing that happening is a lack of research specifically in pregnant or lactating people, but getting those studies done is tricky. That's even as two large clinical trials, partly run in South Africa, show the HIV prevention shot, CAB-LA, is effective.

The country's medicines regulator is yet to approve the long-acting injectable antiretroviral, which is taken every two months. The US Food and Drug Administration has not approved CAB-LA for pregnant and breastfeeding woman.

There are tablets that help prevent the contraction of HIV, but these have to be taken daily to be effective. For a possibly nauseous, and often young and vulnerable woman, keeping up with that regimen is hard.

There is also the question of price, something governments are now haggling over with producers. Regardless, Bekker points out that preventing transmission to babies is cheaper, because the alternative is decades of treatment.

"So being able to give them a long-acting agent, during that time, I think would be incredibly powerful," Bekker said. "In South Africa, we've got this double-whammy where we need to protect young woman and we need to protect the unborn children."

Still, evidence that CAB-LA is low-risk for use by this group of people is needed. The question then is whether there's already enough information that shows acceptable safety — and if there isn't, how best to get it as quickly as possible.

"It's about protecting woman and unborn children through research, rather than from research," she said. "We don't want to wait 12 years. We need to close the ongoing gap of vertical transmission." — Janice Kew

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