b.HIVと母子感染(3.周産期)

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Mother-to-Child verical transmission of HIV can be preventable if diagnosed as HIV infected during pregnancy, and the following measures are undertaken. a) administration of anti-HIV drugs to the pregnant mother, b) caesarean section prior to uterine contractions. ) complete removal of maternal blood from the baby immediately after the birth. d)prophylactic administration of anti HIV drugs to the newborn. e) cessation of milk secretion of the mother. The average ratio of HIV transmission was 30%, until preventable measures were undertaken. The ratio has fallen to less than 2%. The administration of the HIV Antibody Test to all pregnant mothers has therefore become of utmost importance in the fight against the spread of HIV/AIDS in Japan. In April 2002, the Obstetrics and Gynaecological Society in Japan issued the recommendations to all members, and highlighted the importance of administering the Antibody Test to all pregnant women who are willing to give birth. The first HIV infected baby was diagnosed in 1987 in Japan, and since then, 248 HIV-positive pregnancies have been registered. During these fifteen years a total of approximately 18 million babies were born, producing a ration of less than 0.001%. Within the Japanese population of 123 million, only 6,995 cases of HIV/AIDS have been reported-a very small rate compared to other countries. These figures being small however, has resulted in a general decrease in levels of concern among the general public and indeed among many medical authorities in this country who question the high cost of administering the HIV Antibody Test to all pregnant mothers. There is a dilemma between the financial cost of conducting the test and the resulting benefit, or seemingly lack thereof, to a society in which HIV/AIDS statistics are considered small or not significant. Aside from the financial aspect, however, there are other factors to consider. Firstly, the average lifespan of an infected baby is reduced to 5 years, and till death the child experiences a miserable quality of life. Secondly, HIV/AIDS can be spread by a STI carrier before they exhibit clinical symptoms. Thirdly, many HIV infected babies become 'AIDS orphans' as their parents are infected and often die prior to their children. A futher financial aspect of this is the high cost of HIV/AIDS treatment to the infected individual. The average cost of treatment for an adult can run to $500,000 while cancer treatments average $100,000 dollars. Therefore, the prevention of the transmission of HIV/AIDS at birth, through the administration of the test is extremely beneficial financially in the long term. The attitude, that the Antibody test is a waste of funds because the number of infected mothers diagnosed by the test is low, is incorrect, and needs to change to take into account the societal problems and potential financial benefits of the long term. Medical authorities and societies in Japan have the opportunity to reduce the transmission of HIV/AIDS at one of its routes-at birth. The following figures help to emphasise this point. 29 infected HIV infected babies were reported during the 15 year period. Of these ; 2 occurred even though all the above procedures were taken, 22 were natural vaginal deliveries in which none of the above measures were taken, and 5 cases could not be followed up.
社団法人日本産科婦人科学会の論文
2002-08-01

b.HIVと母子感染(3.周産期)

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