Call for HIV screening after baby infected

Health and Disabilities Commissioner Ron Paterson criticised 'sloppy practice'. File picture / Bay of Plenty Times

The Health and Disability Commissioner is calling for a review of the national HIV screening programme for pregnant women after an untested mother infected her baby.

Health and Disabilities Commissioner Ron Paterson today released his finding after an infectious diseases physician complained on behalf of the infected baby's parents.

The baby, known only as Master Y, was born in October 1999 to a Thai mother, known as Ms X, who moved to New Zealand in the late 1990s.

Master Y was diagnosed as HIV-positive at 18 months old only after his mother, who had suffered ongoing health problems, was tested.

In his decision, Mr Paterson found Ms X did not receive a comprehensive pregnancy risk assessment -- including the risk of an HIV infection -- from her public hospital midwife. Unexplained anaemia and cervical smear abnormalities were not investigated.

"The failure to follow-up abnormal test results and to offer an HIV test during Ms X's pregnancy had very serious consequences."

Although it was common practice not to assess a pregnant woman's HIV infection risk, "sloppy practice throughout New Zealand in this area is not to be condoned because everyone is sloppy".

The commissioner said he had brought the matter to the attention of Health Minister Annette King and the Director-General of Health Karen Poutasi.

Aids Foundation executive director Rachael Le Mesurier said today the case was an "almost wholly preventable tragedy".

"If pregnant women are known to have HIV, much can be done to maintain their good health, avoid ongoing transmission and to prevent the child from also being infected."

However, New Zealand's practice of relying on antenatal providers to "selectively screen" for risk before offering HIV testing was shown internationally to be ineffective, particularly when the profile of an at risk mother was changing.

"For example, asking a woman if she has ever been a sex worker is not effective," Ms Le Mesurier said.

"Sex workers in New Zealand in general have very good safe sex practices and are less likely to be at risk than, say, a young New Zealand woman who has had unsafe sex when on their OE in Africa, India or China."

In 2003, five children born in New Zealand were infected with HIV at or around the time of birth, Ms Le Mesurier said.

With mother-to-child transmission rates without medical intervention at one-in-four, it suggested a further 15 women who didn't know they were HIV-positive gave birth in that year.

"This shows that a universal screening HIV programme for all pregnant women should be implemented with some urgency," she said.

- NZPA