Mumbai Achieves Milestone: Zero HIV Cases Transmitted from Mothers to Infants | Mumbai News

Mumbai: The city reported zero cases of HIV transmission from mother to infant in 288 babies born to HIV-positive mothers last year. The success is part of a broader trend in Maharashtra, where, about 5,000 HIV-positive women gave birth in the last five years, with 128 of the infants diagnosed as HIV-positive—a steep drop from the nearly 300 cases recorded in the pre-Covid five-year period.
Mumbai reported six positive cases out of 283 tested in 2019-20. The figures in the following years were: five cases, 311 tests; four cases, 347 tests; one case, 263 tests (in 2022-23). Key to the city’s and the state’s success has been the introduction of a single-tablet antiretroviral regimen, combining Tenofovir, Lamivudine, and Dolutegravir (TLD). Launched nationwide in 2020, TLD provides potent viral suppression with fewer side effects, ensuring treatment adherence for mothers and improved outcomes for infants.
India’s prevention of parent-to-child transmission (PPTCT) protocols began evolving in 2009, when the National AIDS Control Organisation (NACO) updated its approach for pregnant women and introduced early infant diagnosis. Infants are started on antiretroviral prophylaxis from birth, tested at set intervals during their first year, and confirmed HIV-negative at 18 months after breastfeeding cessation. In 2013, the shift to triple-drug therapy marked a gradual decline in the numbers, cutting infant positivity rates from 15.11% the earlier year to 9.35% then.
“The earlier (2013) triple-drug therapy was effective but came with psychological side effects for mothers, leading some to discontinue treatment. The introduction of TLD has been a game-changer. Mothers no longer need to take multiple pills, and side effects are far less common,” said Dr Priya Patil, Head of the Medicine Department at JJ Hospital. Infant positivity rates have dropped to 2%.
But private practitioners say even these numbers are inexcusable and should be zero. “With the current medicines and protocols, no child should be born HIV-positive in India,” said Dr Ishwar Gilada, president-emeritus, AIDS Society of India. Dr JK Maniar, an HIV specialist at Jaslok Hospital, said, “The current three-drug combination brings down viral load to undetectable levels, keeping the child safe.”
Public health experts point to several challenges at public setups. “”Care and medicine are excellent… But pregnant women often arrive late or face social and economic barriers that interrupt treatment. Some even migrate without informing hospitals, making follow-up for AIDS control societies difficult,” said Dr Srikala Acharya, former additional project director, Mumbai District AIDS Control Society.
Covid further disrupted these efforts. “We ensured antiretroviral medicines reached patients’ doorsteps, but testing suffered,” said MSACS Deputy Director Neelam Lawand.