HIV tests for all pregnant women

By Martin Johnston.- All pregnant women will be offered a blood test for HIV under a new scheme to be introduced first in Auckland and Waikato. The Health Ministry announced the policy yesterday, two hours after Health and Disability Commissioner Ron Paterson published a report critical of the existing, patchy screening of pregnant women for HIV, the virus that leads to Aids. He also criticised an unnamed midwife and hospital for not assessing the risk of HIV in a Thai immigrant when she was pregnant in 1999. She and her son were diagnosed with the disease in 2001, when the mother's ophthalmologist suggested an HIV test after reviewing an eye problem. Waikato Hospital infectious diseases physician Dr Graham Mills, who initiated the complaint to the commissioner for the boy's parents, said yesterday that the child, now aged 5, had to drink bad-tasting anti-HIV medicine three times daily, suffered developmental delay and was likely to die before he reached 20. Although HIV treatment had improved, children fared worse than adults because of the difficulties of sticking to the daily treatment regimen. Dr Mills strongly supported a national voluntary screening programme, which he said would be cost-effective and end the "Russian roulette" of not knowing which pregnant women had HIV. Three to five New Zealand-born babies are diagnosed with HIV each year, but experts say the actual number infected is probably higher. Last year, 157 people of all ages were diagnosed with HIV by antibody testing, up sharply from around 100 a year in the 1990s. The voluntary test, if a woman opts for it, will be run on a blood sample already routinely taken to check for hepatitis, syphilis and other conditions. Health Ministry spokesman Pat Tuohy said many developed countries, including Australia and Britain, already offered routine antenatal HIV screening. He expected the national programme would cost up to $2 million a year, including $11 a test for the nearly 60,000 births that took place every year. Auckland City Hospital physician Dr Lucille Wilkinson, who treats pregnant women with HIV, said caring for each child with HIV could cost millions over their lifetime. Children with HIV required high levels of specialist care in hospital and cocktails of drugs costing at least $20,000 a year. Dr Wilkinson welcomed the introduction of screening. "You can't tell from the outside whether someone has got HIV. [Screening] can prevent unnecessary disasters." The ministry introduced guidelines in 1997 that told health workers to offer an HIV test to those considered at risk of HIV - or where risk factors were unclear - including those who had had sex with people from Africa or Asia or other places at high risk for HIV/Aids.HIV and pregnancy * Babies born to a mother with untreated HIV have a 25 to 30 per cent chance of infection. * That falls to less than 1 per cent with treatment in newly diagnosed cases if drug therapy starts by about 27 weeks of pregnancy. * Children with HIV require high levels of specialist hospital care and cocktails of drugs costing at least $20,000 a year.