Causes, Modes and Preventive measures in HIV Mother Only for Education Purpose References: IAP Textbook of Pediatrics 2015

1. -Kranthi Chiluka

2. Total number of Children Living with
HIV/AIDS
In
INDIA
10,00,000

3. 9,50,000 (95%)
Occur Due
To
Vertical Transmission
From
Infected Parents
All These Cases CAN BE PREVENTED By Taking
Adequate Measures

4. VERTICAL TRANSMISSION OF HIV-1
It is an important and unique aspect of pediatric AIDS.
In developing countries 95% of cases in children occur
due to vertical transmission from their infected parents.
Potential routes of infection include :
1. Admixture of maternal fetal blood
2. Infection across the placenta
antenatally
3. Extensive mucocutaneous exposure to
maternal blood and vaginal secretions intranatally.

5.  High viral load in the maternal circulation
 Maternal seroconversion just before delivery
 Vitamin A deficiency in mother
 > 4-hr duration of rupture of membrane
 Vaginal delivery
 STD in mother
Factors which may increase rate of vertical
transmission of HIV-1 are:

6.  Delivery before 34 weeks
 Birth weight < 2.5 kg
 Detectable p24 antigen in maternal serum
 Absence of neutralizing antibodies in maternal
serum
 Maternal CD4+ count less than 700/cumm or
CD4+/CD8+ ratio less than 0.6.

7. BREAST MILK ACQUIRED HIV-I
INFECTION
However WHO advocates breastfeeding in view of high
mortality related to
- Diarrhea
- Malnutrition and
- Respiratory Disease
1. Virus load in the breast milk and
2. Length of time the child is fed.
Transmission through breastfeeding seems to be
related to the
Needs to be decided on individual merit depending on hygiene
and socio-economic factors.

8. When a pregnant women presents during pregnancy,
she should be given ART as follows (to prevent
MTCT):
1. Antepartum: Oral AZT 300 mg BD from 28 weeks
gestation or as soon as feasible.
2. Intrapartum: AZT continued as 300 mg at onset of
labor and 300 mg every 3 hrly till labor.
Also 3TC 150 mg every 12 hrly till labor
Also single dose NVP 200 mg at onset of labor
3. Postpartum: Oral AZT 300 mg BD and 3TC 150 mg
BD for 7 days.
For the baby:
NVP single dose 2 mg/kg within 72 hours of birth and oral AZT 2
mg/kg 4 times a day for 7 days.
Azidothymidine (AZT) Lamivudine (3TC) Nevirapine (NVP)

10. By:
Kranthi Chiluka
Guntur Medical College
Guntur,
Andhra Pradesh
India
For Info:
Write to kranthijosdev@gmail.com