The Bickerstaff Pediatric Family Center at Miller Children’s Hospital Long Beach is celebrating 15 consecutive years of zero HIV transmissions from mother to baby, while in care at Miller Children's. Transmission of HIV from mother to baby has decreased in developed countries, such as the United States, and recently the rate of overall transmission is down under one percent. However, the Bickerstaff Center has consistently focused on staying on top of leading research and treatment initiatives to maintain zero transmissions since the early 1990s.

Early in the program, Miller Children’s infectious disease specialists partnered with obstetricians who did elective cesarean sections before medications were available and now, the HIV community and Bickerstaff Center have medications available that make a cesarean section no longer always necessary.

“Although many HIV programs have had improvements over the years, Miller Children’s is unique and very proud that we have consistently been at zero transmissions for 15 consecutive years,” says Audra Deveikis, medical director, Bickerstaff Pediatric Family Center. “We have had zero transmissions since the early 1990’s, with all the changes in HIV care over the years and new drugs that have come out, it’s quite a remarkable feat.”  

Research efforts have played a tremendous part in the 15 year streak. In partnership with the National Institute of Health (NIH), the Bickerstaff Center participates in national and international research studies, such as International Maternal, Pediatric and Adolescent AIDS Clinical Trials Group (IMPAACT), to determine successful treatment regimens. Being a part of research initiatives ensures quality control, evaluation of the appropriate dosing of medications and new medications that can advance the treatment of the disease.

New mothers who enter the Bickerstaff Family Center are placed on HAART – a highly active antiretroviral therapy. It is the combination of at least three ARV drugs that attack different parts of HIV or stop the virus from entering blood cells. The treatment regiment reduces the quantity of virus in the blood and this has been shown to prevent transmissions from mother to baby.

“Each patient, no matter their situation, gets the individualized attention and follow-up,” says
Dr. Deveikis. “Many pregnant women go on their meds and do well. Some have dual diagnosis like substance dependency or mental illness, which can make it more challenging to keep in care, but we take each one seriously and maximize our efforts to offer the treatment and resources needed to have a healthy baby.”

However, it takes more than medicine for successful zero transmission rates. The Bickerstaff Center offers a multi-disciplinary, family centered care approach through its HIV and Infectious Disease Care programs. The Bickerstaff care team sees the parents together when possible, and works with mothers and their babies to keep the mother-baby bond. New mothers are counseled and worked with throughout their pregnancy to learn ways to manage their disease, as well as ensure the safety of their baby once born, by learning breastfeeding risks when HIV positive.

Dr. Deveikis also credits their success, in part, to the close partnership with the MemorialCare Center for Women’s perinatalogist and obstetricians. “Miller Children’s is a unique children’s hospital because not only does it care for infants and teens, but also expectant mothers all under one roof,” says Dr. Deveikis. “Infectious disease specialists, like myself and our team, are in constant contact and have worked closely with these obstetricians for years to devise the best continuum of care for our patients. We see each other in the hospital and are constantly consulting and collaborating on each case.”

The Bickerstaff Pediatric Family Center hopes to continue to work intensively to maximize prevention efforts to continue to convert a highly lethal infection into a chronic disease with the potential of normal life expectancy in adults and reach the 30 year mark.

“Even having just one transmission is one too many,” says Dr. Deveikis. “Physicians, patients, community leaders and philanthropic friends, such as the Bickerstaff family have all contributed to our success. We are learning to control the disease and hope to eventually cure it.”

About the Bickerstaff Pediatric Family Center
The Bickerstaff Pediatric Family Center at Miller Children’s cares for infants, children, adolescents and pregnant women who are at risk for, or infected with, HIV/AIDS, acute community-acquired illnesses, chronic infections and other immunological disorders. Board-certified infectious disease physicians and the care team also advise on immunization and infectious disease prevention.