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HIV pregnancy often results in HIV infant unless expensive ART therapy or Vitamin D

All data on this page is from Perplexity AI

ActionCost% infants with HIV
Do nothing $0 25%
Add vitamin D $5 17%
Antiretroviral Therapy $500-$5,000 2%

HIV Transmission from Mother to Child During Pregnancy

Without treatment, 25-30% of infants born to HIV-positive mothers will acquire HIV 1.
However, with proper medical intervention, this risk can be reduced to less than 1-2% in developed countries 2 3.

Transmission Rates Without Treatment

In the absence of any intervention, the risk of mother-to-child HIV transmission ranges from 15-45% 4. More specifically:

  • 15-30% transmission occurs during pregnancy and labor 5 6 7
  • 10-20% additional risk comes from breastfeeding 5 8
  • Overall transmission rates without treatment are approximately 25-30% 1 7

The transmission risk varies by geographic region, with studies showing rates of 14-20% in European countries and up to 43% in African countries before treatment became widely available 2.

Transmission Rates With Treatment

Modern antiretroviral therapy (ART) has dramatically reduced transmission rates:

  • Less than 2% transmission risk when mothers receive treatment and infants receive prophylaxis 1 3
  • 0.1-0.3% transmission rates when mothers have undetectable viral loads at delivery 2
  • Less than 1% transmission rate is achievable with optimal care 3 9
Current Statistics in Developed Countries

In the United States, significant progress has been made:

  • 0.9% transmission rate achieved in 2019, meeting elimination goals 10
  • 32 perinatal HIV cases reported in 2019, down from 74 in 2010 10
  • Less than 200 infants infected annually since 2010 7

Similar success has been seen in other developed countries, with transmission rates of 0.2% in France and 0.3% in the UK 2.

Timing of Transmission

When transmission does occur without intervention:

  • 20% of transmissions happen before 36 weeks of gestation 9
  • 50% occur between 36 weeks and delivery 9
  • 30% happen during active labor and delivery 9
Prevention Strategies

The dramatic reduction in transmission rates is achieved through:

  • HIV testing during pregnancy and early treatment initiation 3
  • Antiretroviral therapy throughout pregnancy to achieve viral suppression 3
  • Cesarean delivery when viral loads are high (>1,000 copies/mL) 3
  • Antiretroviral prophylaxis for newborns for 4-6 weeks after birth 3
  • Avoiding breastfeeding in resource-rich settings 3

The implementation of these comprehensive prevention strategies has made mother-to-child HIV transmission largely preventable in settings with access to modern healthcare, transforming what was once a 25-30% risk into a less than 1% probability of transmission.
References

  1. https://www.health.state.mn.us/diseases/hiv/prevention/perinatal.html
  2. https://www.aidsmap.com/about-hiv/how-likely-mother-child-transmission-hiv
  3. https://hivinfo.nih.gov/understanding-hiv/fact-sheets/preventing-perinatal-transmission-hiv-during-pregnancy-and-childbirth
  4. https://www.who.int/teams/global-hiv-hepatitis-and-stis-programmes/hiv/prevention/mother-to-child-transmission-of-hiv
  5. https://pmc.ncbi.nlm.nih.gov/articles/PMC2907958/
  6. https://pmc.ncbi.nlm.nih.gov/articles/PMC4085844/
  7. https://emedicine.medscape.com/article/1385488-overview
  8. https://pmc.ncbi.nlm.nih.gov/articles/PMC3382106/
  9. https://www.hiv.uw.edu/pdf/prevention/preventing-perinatal-transmission/core-concept/all
  10. https://stacks.cdc.gov/view/cdc/131540/cdc_131540_DS1.pdf
  11. https://news.weill.cornell.edu/news/2021/04/new-clues-to-the-conundrum-of-mother-to-child-hiv-transmission
  12. https://pmc.ncbi.nlm.nih.gov/articles/PMC7752838/
  13. https://www.ncbi.nlm.nih.gov/books/NBK558972/
  14. https://publications.aap.org/pediatrics/article/153/6/e2024066843/197305/Infant-Feeding-for-Persons-Living-With-and-at-Risk
  15. https://www.marchofdimes.org/find-support/topics/pregnancy/hiv-and-pregnancy
  16. https://www.aidsmap.com/about-hiv/estimated-hiv-risk-exposure
  17. https://www.cdc.gov/nchhstp/director-letters/cdc-publishes-new-hiv-surveillance-reports.html
  18. https://www.cdc.gov/hiv-data/nhss/national-hiv-prevention-and-care-objectives-2025.html
  19. https://www.hiv.gov/hiv-basics/overview/data-and-trends/statistics
  20. https://data.unicef.org/topic/hivaids/emtct/
  21. https://www.who.int/data/gho/data/themes/hiv-aids/data-on-the-hiv-aids-response
  22. https://pmc.ncbi.nlm.nih.gov/articles/PMC11643157/
  23. https://clinicalinfo.hiv.gov/en/guidelines/perinatal/introduction
  24. https://gh.bmj.com/content/7/9/e009927

Vitamin D Deficiency and Increased HIV Transmission Risk from Mother to Infant

Yes, an infant is more likely to be HIV positive if the mother has HIV and also has low levels of vitamin D.
Research has demonstrated a significant association between maternal vitamin D deficiency and increased risk of mother-to-child HIV transmission.

Key Research Findings: 46% higher risk of Vitamin D < 32 ng

The most comprehensive evidence comes from a landmark study conducted in Tanzania that examined 884 HIV-infected pregnant women. This research found that mothers with low vitamin D levels (below 32 ng/mL) had a 46% higher overall risk of transmitting HIV to their infants compared to mothers with adequate vitamin D levels 1 2 3.
The study revealed several specific transmission risks associated with maternal vitamin D deficiency:

  • 50% higher risk of mother-to-child HIV transmission at 6 weeks after birth 3
  • 2-fold higher risk of HIV transmission through breastfeeding among children who were initially HIV-negative at 6 weeks 3
  • 61% higher risk of infant death during follow-up for children born to vitamin D-deficient mothers 1 3
Mechanisms Behind Increased Risk

Vitamin D plays a crucial role in immune system function, which helps explain why deficiency increases HIV transmission risk. Vitamin D is known to contribute to the development of the fetal immune system; a stronger immune system may be more resistant to HIV infection 1.
Specifically, vitamin D affects HIV transmission through several immunological mechanisms:
Enhanced Immune Defense: Vitamin D activates genes and pathways that enhance both innate and adaptive immunity 4. It induces antiviral gene expression, reduces the viral co-receptor CCR5 on CD4+ T-cells, and promotes an HIV-1-restrictive immunophenotype 4.
Inflammation Reduction: Vitamin D deficiency is linked to increased inflammation and immune activation, which can facilitate HIV transmission 4 5. The vitamin helps suppress pro-inflammatory cytokines such as TNF-α, IFN-γ, IL-2, and IL-12 5.
Antimicrobial Peptide Production: Vitamin D stimulates production of cathelicidin and β-defensin 4, antimicrobial peptides whose functions include inhibition of viral replication 5.

Additional Health Impacts

Beyond HIV transmission, maternal vitamin D deficiency was associated with other adverse outcomes in HIV-exposed children. Research showed that children born to mothers with low vitamin D status had:

  • 29% increased risk of stunting (height-for-age z-score below -2) 6
  • 33% increased risk of being underweight (weight-for-age z-score below -2) 6
  • Higher likelihood of respiratory infections during follow-up 6
Prevention Context

It's important to note that while vitamin D deficiency increases transmission risk, modern HIV prevention strategies are highly effective. With optimal care including antiretroviral therapy during pregnancy and other preventive measures, HIV transmission rates have been reduced to as low as 0.1-0.3% in well-resourced settings 7. However, vitamin D supplementation could serve as an additional protective factor, particularly in resource-limited settings where access to optimal HIV care may be limited 1.
The research suggests that vitamin D supplementation could prove to be a relatively simple and inexpensive method to lower mortality among children and help prevent mother-to-child transmission of HIV as an adjunct to HIV therapy 1. However, while observational studies show these associations, randomized controlled trials would be needed to definitively prove causation and establish optimal supplementation protocols 8 9.
References

  1. https://www.aidsmap.com/news/aug-2009/low-maternal-vitamin-d-increases-risk-hiv-transmission-child-and-infant-mortality
  2. https://pmc.ncbi.nlm.nih.gov/articles/PMC3749690/
  3. https://pubmed.ncbi.nlm.nih.gov/19673647/
  4. https://pmc.ncbi.nlm.nih.gov/articles/PMC5857570/
  5. https://www.sciencedirect.com/science/article/pii/S2405844023067452
  6. https://pubmed.ncbi.nlm.nih.gov/22252204/
  7. https://www.aidsmap.com/about-hiv/how-likely-mother-child-transmission-hiv
  8. https://journals.plos.org/plosmedicine/article?id=10.1371%2Fjournal.pmed.1003973
  9. https://dash.harvard.edu/bitstreams/7312037e-88ed-6bd4-e053-0100007fdf3b/download
  10. https://www.health.state.mn.us/diseases/hiv/prevention/perinatal.html
  11. https://www.who.int/teams/global-hiv-hepatitis-and-stis-programmes/hiv/prevention/mother-to-child-transmission-of-hiv
  12. https://hivinfo.nih.gov/understanding-hiv/fact-sheets/preventing-perinatal-transmission-hiv-after-birth
  13. https://www.aafp.org/pubs/afp/issues/2021/0700/p58.html
  14. https://news.weill.cornell.edu/news/2021/04/new-clues-to-the-conundrum-of-mother-to-child-hiv-transmission
  15. https://pmc.ncbi.nlm.nih.gov/articles/PMC3750101/
  16. https://www.sciencedirect.com/science/article/pii/S002231662213110X
  17. https://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0228900
  18. https://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0236510
  19. https://www.sciencedirect.com/science/article/pii/S0002916523062299
  20. https://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0008770
  21. https://academic.oup.com/jid/article/200/7/1022/903266
  22. https://vivo.weill.cornell.edu/display/pubid21916603
  23. https://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0040036
  24. https://www.natap.org/2011/HIV/051911_01.htm
  25. https://www.infectiousdiseaseadvisor.com/features/influence-of-vitamin-d-in-hiv-infection/
  26. https://pmc.ncbi.nlm.nih.gov/articles/PMC3666828/
  27. https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2019.02291/full
  28. https://publichealth.uga.edu/vitamin-d-deficiency-may-limit-immune-recovery-in-hiv-positive-adults/
  29. https://www.aidsmap.com/news/nov-2012/low-levels-vitamin-d-associated-poorer-long-term-cd4-cell-gains-women-who-start-hiv
  30. https://onlinelibrary.wiley.com/doi/10.1155/2015/735615
  31. https://www.mdpi.com/2673-5601/4/4/35
  32. https://pmc.ncbi.nlm.nih.gov/articles/PMC3902982/
  33. https://pubmed.ncbi.nlm.nih.gov/35427363/

Risk of infant getting HIV - Perplexity AI June 2025

 Download the PDF from VitaminDWiki

  1. Overview HIV and vitamin D
  2. Pregnant women in HIV therapy adding Vitamin D had 3X fewer deaths - RCT April 2022
  3. HIV treatment augmented by high-dose vitamin D, daily or weekly – Dec 2021
  4. Those with HIV who doubled their vitamin D levels reduced their chance of death by 47 percent – Oct 2013
  5. A gut-friendly form of vitamin D should be used for those with HIV and gut problems
  6. Vitamin D can inhibit enveloped virus (e.g. Corona, Herpes, Bird Flu, Epstein, Hepatitis, RSV, etc.) – March 2011
    Examples:   Coronavirus, HIV, H5N1 bird flu, Herpes simplex (cold sore), Shingles, Epstein-Barr, Hepatitis A & B & C, HMPV, Zika, Dengue, Yellow fever, Measles, Mumps, smallpox, Monkeypox, Ebola, rabies, influenza, West Nile, Valley Fever, Croup, Lasa Fever, Hemorrhagic Fever


HIV pregnancy often results in HIV infant unless expensive ART therapy or Vitamin D        
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