This document provides guidelines for managing HIV infection in pregnancy. It discusses counseling pregnant women who test positive for HIV, antenatal care including investigations and treatment with antiretroviral therapy, preventing mother-to-child transmission through medication and delivery methods, care during labor and delivery, testing and treatment for infants, and postpartum care of both mother and baby. The goal is to reduce the risk of transmitting HIV from mother to child to less than 2% through screening, testing, antiretroviral treatment, and modifying delivery and infant feeding practices.
HIV and Pregnancy : Dr Ruby Bansal (1st Session of DGF HIV Committee on 10th ...Lifecare Centre
This document discusses HIV and pregnancy in India. Some key points:
- Over 21 million people live with HIV in India, including 880,000 women. 60% of pregnant women with HIV access antiretroviral therapy (ART).
- ART and other interventions can reduce the risk of parent-to-child HIV transmission to under 2%. Without treatment, transmission rates range from 15-45%.
- Timely diagnosis and treatment of HIV-positive pregnant women is important to prevent transmission to infants. Options include different ART regimens starting during pregnancy, delivery, or breastfeeding depending on when the woman is diagnosed.
- Close coordination between HIV physicians, gynecologists, and other care providers is
HIV DURING PREGNANCY, this is very common and very dangerous disease during pregnancy. this is for medical and nursing student. i tried to make understand of students.
Based on the current NACO guidelines for prevention of parent to child transmission of HIV in India. Also describes the medication, testing and followup of children born to HIV positive mothers.
The document discusses prevention of parent-to-child transmission (PPTCT) of HIV. It outlines NACO's four-pronged strategy for PPTCT, which includes primary prevention of HIV among women, preventing unintended pregnancies in HIV+ women, preventing transmission from mother to child, and treatment/care for women and children living with HIV. It then discusses factors influencing transmission risk and interventions to reduce risk during pregnancy, delivery, and infancy including antiretroviral prophylaxis and therapy.
1) Prevention of Mother to Child Transmission (PMTCT) programs provide antiretroviral drugs, counseling, and support to pregnant women living with HIV to reduce the risk of transmitting the virus to their babies during pregnancy, childbirth, and breastfeeding.
2) Key interventions include antiretroviral prophylaxis for pregnant and breastfeeding women and their infants, safer delivery and infant feeding practices, and treatment, care and support for women and families.
3) In Tanzania, the national PMTCT program incorporates antiretroviral prophylaxis including various combination drug regimens during antenatal, intrapartum, postpartum, and infant periods, depending on when
The PPTCT program in India provides services through ICTCs to test pregnant women for HIV and prevent mother-to-child transmission. If tested positive, women receive counseling, ART treatment, monitoring, and are encouraged to have institutional deliveries. Infants receive post-exposure prophylaxis. The goal is to eliminate vertical transmission through antenatal, intrapartum, postnatal care and promoting safe infant feeding practices.
This document provides guidelines for managing HIV in pregnancy. It discusses screening all pregnant women for HIV and other infections. For HIV-positive mothers, it recommends prompt referral to a multidisciplinary team and starting combination antiretroviral therapy (cART) by 14 weeks of pregnancy to prevent mother-to-child transmission. The guidelines cover antenatal care, immunization, labor and delivery recommendations depending on viral load, and neonatal and postpartum management of HIV-positive mothers and exposed infants. The overall aim is to optimize care and reduce risk of HIV transmission through comprehensive antenatal and delivery protocols.
HIV and Pregnancy : Dr Ruby Bansal (1st Session of DGF HIV Committee on 10th ...Lifecare Centre
This document discusses HIV and pregnancy in India. Some key points:
- Over 21 million people live with HIV in India, including 880,000 women. 60% of pregnant women with HIV access antiretroviral therapy (ART).
- ART and other interventions can reduce the risk of parent-to-child HIV transmission to under 2%. Without treatment, transmission rates range from 15-45%.
- Timely diagnosis and treatment of HIV-positive pregnant women is important to prevent transmission to infants. Options include different ART regimens starting during pregnancy, delivery, or breastfeeding depending on when the woman is diagnosed.
- Close coordination between HIV physicians, gynecologists, and other care providers is
HIV DURING PREGNANCY, this is very common and very dangerous disease during pregnancy. this is for medical and nursing student. i tried to make understand of students.
Based on the current NACO guidelines for prevention of parent to child transmission of HIV in India. Also describes the medication, testing and followup of children born to HIV positive mothers.
The document discusses prevention of parent-to-child transmission (PPTCT) of HIV. It outlines NACO's four-pronged strategy for PPTCT, which includes primary prevention of HIV among women, preventing unintended pregnancies in HIV+ women, preventing transmission from mother to child, and treatment/care for women and children living with HIV. It then discusses factors influencing transmission risk and interventions to reduce risk during pregnancy, delivery, and infancy including antiretroviral prophylaxis and therapy.
1) Prevention of Mother to Child Transmission (PMTCT) programs provide antiretroviral drugs, counseling, and support to pregnant women living with HIV to reduce the risk of transmitting the virus to their babies during pregnancy, childbirth, and breastfeeding.
2) Key interventions include antiretroviral prophylaxis for pregnant and breastfeeding women and their infants, safer delivery and infant feeding practices, and treatment, care and support for women and families.
3) In Tanzania, the national PMTCT program incorporates antiretroviral prophylaxis including various combination drug regimens during antenatal, intrapartum, postpartum, and infant periods, depending on when
The PPTCT program in India provides services through ICTCs to test pregnant women for HIV and prevent mother-to-child transmission. If tested positive, women receive counseling, ART treatment, monitoring, and are encouraged to have institutional deliveries. Infants receive post-exposure prophylaxis. The goal is to eliminate vertical transmission through antenatal, intrapartum, postnatal care and promoting safe infant feeding practices.
This document provides guidelines for managing HIV in pregnancy. It discusses screening all pregnant women for HIV and other infections. For HIV-positive mothers, it recommends prompt referral to a multidisciplinary team and starting combination antiretroviral therapy (cART) by 14 weeks of pregnancy to prevent mother-to-child transmission. The guidelines cover antenatal care, immunization, labor and delivery recommendations depending on viral load, and neonatal and postpartum management of HIV-positive mothers and exposed infants. The overall aim is to optimize care and reduce risk of HIV transmission through comprehensive antenatal and delivery protocols.
Option B+ proposes providing lifelong antiretroviral therapy (ART) to all HIV-infected pregnant women beginning in antenatal clinics, continuing after delivery for life. This further simplifies services and harmonizes with ART programs. It also protects against transmission in future pregnancies and to partners. While benefits need evaluation, it is an appropriate time for countries to assess experience and options to make optimal choices. WHO advises all countries to examine goals and experiences to better integrate PMTCT and ART, with evidence from Option B+ implementation helping to inform future guidelines.
This document discusses HIV infection in pregnancy and strategies to reduce mother-to-child transmission of HIV. It covers antepartum, intrapartum, and postpartum care for HIV-infected women including antiretroviral regimens, monitoring, testing protocols, and delivery methods. The goal is to reduce the risk of perinatal HIV transmission to less than 2% through highly effective antiretroviral therapy, elective cesarean section when appropriate, and avoiding breastfeeding.
1) The document discusses pharmacological principles for treating HIV in pregnant women to reduce mother-to-child transmission.
2) Updated perinatal guidelines from 2007 recommend initiating HAART after 14 weeks of gestation and continuing treatment throughout pregnancy, labor, and delivery.
3) Clinical scenarios provide examples of applying the guidelines, such as recommending HAART, scheduled C-sections if viral load is high, and 6 weeks of infant ZDV treatment starting within hours of birth.
Acceptability of HIV Counselling and Testing among Healthcare Workers and Pre...Helen Madamba
The document reports on a study that assessed the acceptability of HIV counseling and testing among healthcare professionals and pregnant women at an urban hospital in the Philippines. A total of 865 participants completed questionnaires on their demographics, HIV knowledge, attitudes towards people with HIV, and views on HIV testing. While both groups showed generally good knowledge of HIV transmission, pregnant women displayed more stigma towards those with HIV. Overall attitudes towards HIV testing were more positive among healthcare professionals. The study concludes that while HIV knowledge is high, stigma reduction programs are still needed to address issues related to HIV prevention and care.
1) Prenatal HIV counseling should be offered to all pregnant women as HIV infected women are prone to various opportunistic infections.
2) Strategies to prevent vertical transmission include decreasing fetal viral exposure by preventing procedures like chorioamniocentesis and shortening the duration of labor.
3) A clinical trial showed that treatment with zidovudine reduced perinatal HIV transmission from 25% to 7%. Newborns exposed to HIV should receive antiretroviral prophylaxis.
This document summarizes guidelines for the prevention of mother-to-child transmission (PMTCT) of HIV in Ethiopia. It outlines the epidemiology of HIV in women and children, defining MTCT and PMTCT. Risks of MTCT are highest without intervention, ranging from 20-45%. The national PMTCT strategy includes: primary HIV prevention; preventing unintended pregnancies in HIV+ women; preventing transmission from mother to child; and treatment, care and support of women and families. Key components are counseling and testing, antenatal care, labor/delivery care, postpartum care, infant care including ARV prophylaxis, and lifelong ART for eligible mothers. National guidelines have opted for WHO PMTCT
The document summarizes updates to PMTCT (prevention of mother-to-child transmission) guidelines from the WHO and DHHS. Key changes include initiating ART for pregnant women at a CD4 count of <350 cells/mm3, starting ART earlier in pregnancy to reduce viral load, and recommending combination ART or HAART as the preferred regimen over AZT alone. The rationale for these changes is the earlier initiation of HAART in non-pregnant adults, the timing of mother-to-child transmission both with and without breastfeeding, and the importance of effective regimens to reduce transmission and prevent resistance. Safety data now supports the use of 3-drug regimens during pregnancy.
This aims to increase awareness on the Philippine HIV Epidemic, how it affects pregnancy and how it can be managed for prevention of mother to child transmission of HIV.
Prevention of Mother to Child Transmission of HIV 2018Helen Madamba
Babies of pregnant women living with HIV can be born free of HIV infection. HIV counselling and testing is the gateway to diagnosis, treatment, care and support. Healthcare services need to provide enabling environments to support and empower women living with HIV and their children, to increase HIV knowledge and reduce stigma and discrimination.
Consolidated guidelines on
the Use of Antiretroviral
Drugs for Treating and
Preventing HIV Infection
Summary of key features and recommendations
JUNE 2013
HIV AND PREGNANCY update (2020) By Dr Rahul Jain & Dr Sharda JainLifecare Centre
This document discusses HIV and hepatitis in pregnancy. It covers the structure and transmission of HIV, stages of HIV infection, treatment strategies including antiretroviral drugs, and considerations for HIV-positive pregnancies such as routine antenatal screening and interventions to prevent mother-to-child transmission. Hepatitis B is discussed as the most common viral hepatitis in pregnancy, and hepatitis E is noted as associated with the highest mortality. Treatment approaches for hepatitis in pregnancy are also outlined.
This lecture describes the approach to screening, diagnosis and management of HIV and TB infection among pregnant patients. Prevention of Mother to Child Transmission of HIV infection mainly based on the Philippine Obstetrical and Gynecological Society Clinical Practice Recommendations.
Mother to child transmission of HIV can occur during pregnancy, childbirth, and breastfeeding. The risk is higher if the mother's HIV infection is in an advanced stage, if she is malnourished, has other STDs, or her membranes rupture early. Antiretroviral therapy and cesarean delivery before labor can reduce transmission risk. Exclusive breastfeeding for 6 months poses a lower risk than mixed feeding. India's PMTCT program provides counseling, testing, antiretroviral prophylaxis to pregnant women and newborns to prevent transmission and aims to reduce transmission by 50% by 2010.
This document provides guidance on the management of HIV in pregnancy. It recommends screening all pregnant women for HIV and other infections. For women who test positive, it recommends a multidisciplinary care team and interventions to prevent transmission to the child and disease progression in the mother, including antiretroviral therapy. It provides guidance on antenatal care, delivery, postpartum care, and management of the neonate to reduce risk of transmission to less than 1%.
HIV 1 and 2 belong to the Lentivirus genus and Retroviridae family. They contain two copies of single-stranded RNA and encode viral core, enzyme, and envelope proteins. Vertical transmission from mother to child is the primary route of infection in children, which can occur prenatally, during delivery, or through breastfeeding. Combination antiretroviral therapy is the standard treatment and involves two nucleoside reverse transcriptase inhibitors plus a non-nucleoside reverse transcriptase inhibitor or protease inhibitor.
2018 Prevention of Mother to Child Transmission of HIV InfectionHelen Madamba
The document discusses prevention of mother-to-child transmission (PMTCT) of HIV in the Philippines. It outlines the objectives of discussing PMTCT program prongs, HIV epidemiology in the Philippines, transmission and management principles, and screening/testing during pregnancy. It provides statistics on increasing HIV prevalence in the Philippines, especially among men who have sex with men, IV drug users, and teenagers/single mothers. Modes of HIV transmission include unprotected sex and needle sharing. The document emphasizes screening, counseling, and ARV treatment during pregnancy and delivery to reduce mother-to-child transmission risk, as well as strategies to prevent unintended pregnancy and support women living with HIV.
HIV in Pregnancy
Dr. ARCHANA VERMA
1) HIV is a retrovirus that can be transmitted from mother to child during pregnancy, childbirth, or breastfeeding. Left untreated, the risk of mother-to-child transmission is 15-45%.
2) Treatment involves antiretroviral therapy for the mother during pregnancy and delivery, and for the newborn for 4-6 weeks to prevent transmission. Mode of delivery and avoiding breastfeeding can also reduce risk.
3) With treatment, the risk of mother-to-child HIV transmission can be reduced to less than 2%. Proper antenatal care, delivery management, and postpartum care and testing of
This document provides information about HIV, pregnancy, and women's health. It discusses how effective HIV treatment can reduce the risk of mother-to-child transmission to almost zero by achieving an undetectable viral load. It explains that transmission usually occurs around the time of labor and delivery or through breastfeeding. The document also covers topics like planning a pregnancy, prenatal care, HIV drug use during pregnancy, delivery options, and feeding options after birth. Resources are provided for additional information and support.
Care of HIV positive Pregnant and breastfeeding women_Feb_1_2023.pptxyakemichael
The document provides an overview of prevention of mother-to-child transmission (PMTCT) of HIV, describing its 4 prongs and continuum of services from antenatal care to postnatal care. It aims to eliminate new HIV infections in children and reduce mortality and morbidity in HIV-positive women and their exposed infants. Key interventions discussed include lifelong antiretroviral therapy (ART) for positive mothers, cotrimoxazole prophylaxis, nutrition support, safe delivery practices, early infant diagnosis, and viral load monitoring throughout pregnancy and breastfeeding.
This document provides guidelines for preventing mother-to-child transmission of HIV (PMTCT) in antenatal care settings. There are four key elements of PMTCT care: primary HIV prevention, preventing unintended pregnancies among HIV+ women, preventing transmission from mother to child, and treatment/support for HIV+ women and their families. The goals of PMTCT in antenatal care are to identify all HIV+ women, provide same-day ART to optimize health and prevent transmission, and ensure viral suppression through treatment. All pregnant women should be tested for HIV and receive counseling. HIV+ women initiate lifelong ART regardless of CD4 count or clinical stage, while HIV- women receive repeat testing during pregnancy and breastfeeding.
Option B+ proposes providing lifelong antiretroviral therapy (ART) to all HIV-infected pregnant women beginning in antenatal clinics, continuing after delivery for life. This further simplifies services and harmonizes with ART programs. It also protects against transmission in future pregnancies and to partners. While benefits need evaluation, it is an appropriate time for countries to assess experience and options to make optimal choices. WHO advises all countries to examine goals and experiences to better integrate PMTCT and ART, with evidence from Option B+ implementation helping to inform future guidelines.
This document discusses HIV infection in pregnancy and strategies to reduce mother-to-child transmission of HIV. It covers antepartum, intrapartum, and postpartum care for HIV-infected women including antiretroviral regimens, monitoring, testing protocols, and delivery methods. The goal is to reduce the risk of perinatal HIV transmission to less than 2% through highly effective antiretroviral therapy, elective cesarean section when appropriate, and avoiding breastfeeding.
1) The document discusses pharmacological principles for treating HIV in pregnant women to reduce mother-to-child transmission.
2) Updated perinatal guidelines from 2007 recommend initiating HAART after 14 weeks of gestation and continuing treatment throughout pregnancy, labor, and delivery.
3) Clinical scenarios provide examples of applying the guidelines, such as recommending HAART, scheduled C-sections if viral load is high, and 6 weeks of infant ZDV treatment starting within hours of birth.
Acceptability of HIV Counselling and Testing among Healthcare Workers and Pre...Helen Madamba
The document reports on a study that assessed the acceptability of HIV counseling and testing among healthcare professionals and pregnant women at an urban hospital in the Philippines. A total of 865 participants completed questionnaires on their demographics, HIV knowledge, attitudes towards people with HIV, and views on HIV testing. While both groups showed generally good knowledge of HIV transmission, pregnant women displayed more stigma towards those with HIV. Overall attitudes towards HIV testing were more positive among healthcare professionals. The study concludes that while HIV knowledge is high, stigma reduction programs are still needed to address issues related to HIV prevention and care.
1) Prenatal HIV counseling should be offered to all pregnant women as HIV infected women are prone to various opportunistic infections.
2) Strategies to prevent vertical transmission include decreasing fetal viral exposure by preventing procedures like chorioamniocentesis and shortening the duration of labor.
3) A clinical trial showed that treatment with zidovudine reduced perinatal HIV transmission from 25% to 7%. Newborns exposed to HIV should receive antiretroviral prophylaxis.
This document summarizes guidelines for the prevention of mother-to-child transmission (PMTCT) of HIV in Ethiopia. It outlines the epidemiology of HIV in women and children, defining MTCT and PMTCT. Risks of MTCT are highest without intervention, ranging from 20-45%. The national PMTCT strategy includes: primary HIV prevention; preventing unintended pregnancies in HIV+ women; preventing transmission from mother to child; and treatment, care and support of women and families. Key components are counseling and testing, antenatal care, labor/delivery care, postpartum care, infant care including ARV prophylaxis, and lifelong ART for eligible mothers. National guidelines have opted for WHO PMTCT
The document summarizes updates to PMTCT (prevention of mother-to-child transmission) guidelines from the WHO and DHHS. Key changes include initiating ART for pregnant women at a CD4 count of <350 cells/mm3, starting ART earlier in pregnancy to reduce viral load, and recommending combination ART or HAART as the preferred regimen over AZT alone. The rationale for these changes is the earlier initiation of HAART in non-pregnant adults, the timing of mother-to-child transmission both with and without breastfeeding, and the importance of effective regimens to reduce transmission and prevent resistance. Safety data now supports the use of 3-drug regimens during pregnancy.
This aims to increase awareness on the Philippine HIV Epidemic, how it affects pregnancy and how it can be managed for prevention of mother to child transmission of HIV.
Prevention of Mother to Child Transmission of HIV 2018Helen Madamba
Babies of pregnant women living with HIV can be born free of HIV infection. HIV counselling and testing is the gateway to diagnosis, treatment, care and support. Healthcare services need to provide enabling environments to support and empower women living with HIV and their children, to increase HIV knowledge and reduce stigma and discrimination.
Consolidated guidelines on
the Use of Antiretroviral
Drugs for Treating and
Preventing HIV Infection
Summary of key features and recommendations
JUNE 2013
HIV AND PREGNANCY update (2020) By Dr Rahul Jain & Dr Sharda JainLifecare Centre
This document discusses HIV and hepatitis in pregnancy. It covers the structure and transmission of HIV, stages of HIV infection, treatment strategies including antiretroviral drugs, and considerations for HIV-positive pregnancies such as routine antenatal screening and interventions to prevent mother-to-child transmission. Hepatitis B is discussed as the most common viral hepatitis in pregnancy, and hepatitis E is noted as associated with the highest mortality. Treatment approaches for hepatitis in pregnancy are also outlined.
This lecture describes the approach to screening, diagnosis and management of HIV and TB infection among pregnant patients. Prevention of Mother to Child Transmission of HIV infection mainly based on the Philippine Obstetrical and Gynecological Society Clinical Practice Recommendations.
Mother to child transmission of HIV can occur during pregnancy, childbirth, and breastfeeding. The risk is higher if the mother's HIV infection is in an advanced stage, if she is malnourished, has other STDs, or her membranes rupture early. Antiretroviral therapy and cesarean delivery before labor can reduce transmission risk. Exclusive breastfeeding for 6 months poses a lower risk than mixed feeding. India's PMTCT program provides counseling, testing, antiretroviral prophylaxis to pregnant women and newborns to prevent transmission and aims to reduce transmission by 50% by 2010.
This document provides guidance on the management of HIV in pregnancy. It recommends screening all pregnant women for HIV and other infections. For women who test positive, it recommends a multidisciplinary care team and interventions to prevent transmission to the child and disease progression in the mother, including antiretroviral therapy. It provides guidance on antenatal care, delivery, postpartum care, and management of the neonate to reduce risk of transmission to less than 1%.
HIV 1 and 2 belong to the Lentivirus genus and Retroviridae family. They contain two copies of single-stranded RNA and encode viral core, enzyme, and envelope proteins. Vertical transmission from mother to child is the primary route of infection in children, which can occur prenatally, during delivery, or through breastfeeding. Combination antiretroviral therapy is the standard treatment and involves two nucleoside reverse transcriptase inhibitors plus a non-nucleoside reverse transcriptase inhibitor or protease inhibitor.
2018 Prevention of Mother to Child Transmission of HIV InfectionHelen Madamba
The document discusses prevention of mother-to-child transmission (PMTCT) of HIV in the Philippines. It outlines the objectives of discussing PMTCT program prongs, HIV epidemiology in the Philippines, transmission and management principles, and screening/testing during pregnancy. It provides statistics on increasing HIV prevalence in the Philippines, especially among men who have sex with men, IV drug users, and teenagers/single mothers. Modes of HIV transmission include unprotected sex and needle sharing. The document emphasizes screening, counseling, and ARV treatment during pregnancy and delivery to reduce mother-to-child transmission risk, as well as strategies to prevent unintended pregnancy and support women living with HIV.
HIV in Pregnancy
Dr. ARCHANA VERMA
1) HIV is a retrovirus that can be transmitted from mother to child during pregnancy, childbirth, or breastfeeding. Left untreated, the risk of mother-to-child transmission is 15-45%.
2) Treatment involves antiretroviral therapy for the mother during pregnancy and delivery, and for the newborn for 4-6 weeks to prevent transmission. Mode of delivery and avoiding breastfeeding can also reduce risk.
3) With treatment, the risk of mother-to-child HIV transmission can be reduced to less than 2%. Proper antenatal care, delivery management, and postpartum care and testing of
This document provides information about HIV, pregnancy, and women's health. It discusses how effective HIV treatment can reduce the risk of mother-to-child transmission to almost zero by achieving an undetectable viral load. It explains that transmission usually occurs around the time of labor and delivery or through breastfeeding. The document also covers topics like planning a pregnancy, prenatal care, HIV drug use during pregnancy, delivery options, and feeding options after birth. Resources are provided for additional information and support.
Care of HIV positive Pregnant and breastfeeding women_Feb_1_2023.pptxyakemichael
The document provides an overview of prevention of mother-to-child transmission (PMTCT) of HIV, describing its 4 prongs and continuum of services from antenatal care to postnatal care. It aims to eliminate new HIV infections in children and reduce mortality and morbidity in HIV-positive women and their exposed infants. Key interventions discussed include lifelong antiretroviral therapy (ART) for positive mothers, cotrimoxazole prophylaxis, nutrition support, safe delivery practices, early infant diagnosis, and viral load monitoring throughout pregnancy and breastfeeding.
This document provides guidelines for preventing mother-to-child transmission of HIV (PMTCT) in antenatal care settings. There are four key elements of PMTCT care: primary HIV prevention, preventing unintended pregnancies among HIV+ women, preventing transmission from mother to child, and treatment/support for HIV+ women and their families. The goals of PMTCT in antenatal care are to identify all HIV+ women, provide same-day ART to optimize health and prevent transmission, and ensure viral suppression through treatment. All pregnant women should be tested for HIV and receive counseling. HIV+ women initiate lifelong ART regardless of CD4 count or clinical stage, while HIV- women receive repeat testing during pregnancy and breastfeeding.
This document summarizes guidelines for preventing mother-to-child transmission (PMTCT) of HIV. It discusses how HIV can be transmitted from mother to child during pregnancy, delivery, and breastfeeding. The overall transmission rate without intervention is 15-45%, which can be reduced below 5% with effective interventions. These include voluntary counseling and testing for pregnant women, access to antiretroviral treatment for HIV-positive mothers and their infants, safe delivery practices, and guidance on infant feeding options. The document provides details on testing and treatment recommendations during the antenatal, intrapartum, and postpartum periods to reduce HIV transmission from mother to child.
This document discusses HIV/AIDS in pregnancy and prevention of mother-to-child transmission (PMTCT) of HIV in Nigeria. It provides statistics on the burden of HIV in Nigeria and describes the primary mode of HIV transmission as sexual contact. It then focuses on mother-to-child transmission, risk factors that increase transmission during pregnancy and delivery, and the benefits of PMTCT for both mother and infant. It also outlines recommended testing, treatment and prevention strategies used in PMTCT programs.
This document provides guidance on the management of HIV in pregnancy. It recommends screening all pregnant women for HIV and other infections. For women who test positive, it recommends a multidisciplinary care team and interventions to prevent transmission to the child and disease progression in the mother, including antiretroviral therapy. It provides guidance on antenatal care, delivery, postpartum care, and management of the neonate to reduce risk of transmission to less than 1%.
This document provides guidance on the management of Hepatitis C in pregnancy. It recommends screening all pregnant women for HCV at their first prenatal visit and retesting those at high risk. For HCV-positive patients, it advises monitoring liver enzymes during pregnancy, discussing transmission risks and treatment with the patient, and considering referral to a hepatology clinic. It also provides guidance on intrapartum care, postpartum management including breastfeeding, neonatal follow-up testing, and contraception during and after antiviral therapy.
1. The document discusses prevention of parent-to-child transmission (PPTCT) of HIV, including that transmission can occur during pregnancy, labor, delivery and breastfeeding. It also discusses the importance of PPTCT for preventing pediatric HIV infections.
2. PPTCT services in India aim to detect positive pregnant women and provide them comprehensive services including antiretroviral treatment (ART). The objectives are to detect over 80% of positive women, provide services to over 90%, and ensure over 95% ART compliance for positive women.
3. Care for HIV exposed infants includes care at birth, infant feeding support, antiretroviral prophylaxis, vaccines, cotrimoxazole
Approximately 8,500 women living with HIV give birth annually in the US. Since the beginning of the AIDS epidemic, almost 5,000 children under age 13 who got HIV through perinatal transmission have died. New HIV infections in children have dramatically declined from 400,000 in 2009 to around 220,000 in 2014 due to efforts like the UNICEF Global Plan. Prevention of perinatal transmission is crucial since there is no HIV vaccine; it requires pregnant women to take antiretroviral therapy consistently during and after pregnancy and avoid breastfeeding. Challenges to prevention include not all pregnant women knowing their HIV status and inconsistent access to treatment.
This document summarizes HIV/AIDS during pregnancy. It discusses how HIV causes AIDS by depleting CD4 cells. Around 25-30% of people with HIV worldwide are women aged 20-49. The document outlines how HIV is transmitted from mother to child, mainly during labor and delivery. It recommends offering HIV testing to all pregnant women and treating HIV-positive mothers with antiretroviral therapy to reduce the risk of transmission to less than 2%. Safety measures during pregnancy, delivery and postpartum are also discussed.
This document provides statistics on the global HIV epidemic in 2018 from UNAIDS as well as information on HIV in India. Some key points:
- 37.9 million people globally were living with HIV in 2018. 1.7 million became newly infected that year while 23.3 million were accessing antiretroviral therapy.
- India has the third largest HIV epidemic in the world. In 2015, the national adult prevalence was 0.26%. Prevalence is highest in certain states like Mizoram (2.04%) and Manipur (1.43%).
- Children account for 6.54% of total PLHIV in India. Early infant diagnosis, appropriate infant feeding and prophylaxis
Early initiation of haart why, when and how 21 juneanil kumar g
This document discusses guidelines for early initiation of HIV treatment. It recommends starting antiretroviral therapy (ART) for all people living with HIV, including pregnant and breastfeeding women, regardless of CD4 count or clinical stage. The benefits of early treatment include reduced progression to AIDS, lower rates of illness and death, and decreased HIV transmission. First-line ART regimens preferably include tenofovir, lamivudine and efavirenz. Viral load testing is the best way to monitor treatment response and detect treatment failure.
Early initiation of HAART why, when and how.anil kumar g
This document discusses guidelines for initiating antiretroviral therapy (ART) for HIV, including for pregnant women, children, and prevention. It recommends starting ART for all people living with HIV at a CD4 count of ≤500 cells/mm3. For pregnant and breastfeeding women, the preferred first-line regimen is tenofovir + lamivudine (or emtricitabine) + efavirenz. Early initiation of ART reduces disease progression and transmission risk, and lifelong ART is recommended for all pregnant and breastfeeding women. Simplified regimens help improve treatment access and outcomes for children.
1) HIV infection during pregnancy poses risks for both mother and baby, with around 13,000 babies born to HIV+ mothers becoming infected each year in India.
2) Strategies to prevent mother-to-child transmission include antiretroviral therapy for the mother during pregnancy and delivery, and for 6 weeks postpartum. Caesarean delivery and avoiding breastfeeding can further reduce risks of transmission.
3) Proper prenatal counseling, treatment, and testing of the newborn are important for management of HIV infection during pregnancy.
Dr k prabha devi new pptct guidelines-1(1)Ratan Yadav
The document outlines new guidelines for initiating ART for HIV-infected pregnant women in India. It recommends providing lifelong ART to all pregnant and breastfeeding women living with HIV, regardless of CD4 count or clinical stage, to prevent mother-to-child transmission. This includes initiating a regimen of TDF+3TC+EFV and continuing it throughout pregnancy, delivery, and breastfeeding. It also details protocols for providing antiretroviral prophylaxis to newborns to reduce HIV transmission and the durations of prophylaxis depending on the mother's ART history.
This document outlines Ghana's Elimination of Mother-to-Child Transmission of HIV (EMTCT) program. The goals of the EMTCT program are to provide comprehensive services to maintain the health of the mother and prevent transmission of HIV from mother to child. The strategies include primary prevention of HIV in women, preventing unintended pregnancies in HIV-positive women, and preventing transmission during pregnancy, delivery and breastfeeding. The document describes the antenatal, delivery, postpartum and newborn care services provided to support EMTCT, including HIV testing, treatment and infant follow up.
This was a lecture given during the CME activitiy for POGS Region 7 by the Philippine Infectious Disease Society for Obstetrics and Gynecology (PIDSOG) at Casino Espanyol in Cebu City.
This document provides guidance on the management of HIV-positive mothers and the prevention of mother-to-child transmission of HIV. It discusses the importance of counseling and voluntary testing for all pregnant women to identify HIV-positive mothers. For those who test positive, it recommends providing antiretroviral therapy based on the mother's CD4 count and clinical stage to treat the mother and prevent transmission to the infant. It also discusses considerations for infant feeding, delivery procedures, postpartum care, and antiretroviral treatment and safety during breastfeeding. The overall goal is to reduce mother-to-child HIV transmission through counseling, testing, antiretroviral interventions, and addressing infant feeding options based on the mother's
Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Kat...rightmanforbloodline
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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Hiv infection in pregnancy
1. HIV INFECTION IN PREGNANCY
• Dr pjca Mbizi
• Dr Ndwambi
• June /2018
2. 1. introduction
2. Overview
3. Counselling a pregnant woman about being
HIV positive
4. Antenatal care
5. Investigations
6. Treatment
7. Labour and delivery
8. HIV prevention and testing for infants
9. Postpartum care
10.References
3. infection with human immunodeficiency virus (hiv) results in acquired immune deficiency syndrome
(aids), and has a high risk of transmission of the virus from an infected pregnant or breastfeeding
woman to her baby.
all women who book for antenatal care should be offered hiv testing,
according to the principles of provider-initiated hiv counseling & testing.
only women who have a documented positive hiv status, and are on antiretroviral therapy (art) are
not offered an hiv test. rapid antibody tests are used.
a positive test is confirmed using another rapid hiv test kit.
if one result is positive and the other is negative, the results are indeterminate and an ELISA must be
done to confirm the hiv status.
Introduction
4. OVERVIEW
• The reduction in mother-to-child transmission of human immunodeficiency virus
(HIV) is regarded as one of the most effective public health initiatives in the
United States. In the absence of treatment, the risk of vertical transmission of HIV
is as high as 25-30%. With the implementation of HIV testing, counseling,
antiretroviral medication, delivery by cesarean section prior to onset of labor, and
discouraging breastfeeding, the mother-to-infant transmission has decreased to
less than 2% in the United States.
• an exact mechanism of mother-to-child transmission of HIV remains unknown.
Transmission may occur during intrauterine life, delivery, or breastfeeding. The
greatest risk factor for vertical transmission is thought to be advanced maternal
disease, likely due to a high maternal HIV viral load.
5. EPIDEMIOLOGY
• International statistics
• The Joint United Nations Programme on HIV/AIDS (UNAIDS) has estimated that in
2017, approximately 36.7 million people worldwide (1% of the global adult
population aged 15-49 y) were infected with HIV, of which 1.8 million people were
newly infected; 64% of all people living with HIV worldwide live in sub-Saharan
Africa. New HIV infection rates are declining globally as a result of efforts to
strengthen HIV prevention and treatment programs.
6. • 2. Establish what the woman knows about HIV
• 3. Give information on how the virus is transmitted
• 4. Discuss the symptoms, signs and progression of the disease
• 5. Explain the importance of CD4 count & viral load (VL) monitoring
• 6. Discuss the benefits and potential side-effects of ART
• 7. Explain the risk of mother-to-child transmission of HIV and how this may be reduced: safe infant
feeding choice and antiretrovirals (ARVs)
• 8. Discuss who the woman may want to tell about the result – disclosure is associated with better
treatment adherence
• 9. Discuss condom use and other safe sex practices to prevent transmission to and from the partner,
and also discuss partner testing
• 10. Discuss future fertility plans, and further contraception
Counselling a pregnant woman about being HIV positive
7. ANTENATAL CARE
Clinical assessment:
• Ask about chronic illnesses in the past, and about current health
• Ask about the presence of any psychiatric illness
• Screen for TB: ask about cough, weight loss, night sweats and fever
• On physical examination, look for evidence of opportunistic infections: oral candidiasis, herpes zoster, and
pulmonary TB
• Look for evidence of sexually transmitted infections and treat appropriately
• Stage the woman according to the World Health Organization staging system
8. • All women who test HIV negative in early pregnancy should be offered a repeat test every 3 months, at the onset of
labour, at 6 weeks postpartum, and every 3 months during breastfeeding.
• Women on ART should have VL monitoring every 3 months throughout pregnancy, then 6-monthly during
breastfeeding
• Creatinine is repeated at 3 months, 6 months, 12 months, then annually while on TDF
• If there is a need for antenatal invasive procedures, initiating ART 6 weeks before the procedure gives some
reassurance of viral suppression to allow the procedure to be done
• Consider elective caesarean section for women likely to require an emergency caesarean section in labour, e.g.
previous caesarean section
• HIV infection alone is not a valid indication for Caesarean section.
9. INVESTIGATIONS:
1. Take blood for CD4 count, Hb and creatinine at ART
initiation, and follow up in one week for results
2. Once on ART, do a VL every 3 months during pregnancy
3. Investigate for TB if screen positive
10. TREATMENT:
Initiate ART, preferably on the day of diagnosis
• Give the usual antenatal supplements, such as folate, iron and calcium
• Give isoniazid preventive therapy (IPT) 300 mg with pyridoxine 25 mg daily for 12 months to all women initiated
on ART who screen TB-negative
• Give cotrimoxazole 2 tablets orally daily to women with CD4 cell count <200/mm3
• Do a serum cryptococcal antigen (CRAG) on asymptomatic women with CD4 <100 cells/mm3. If positive, start oral
fluconazole pre-emptive therapy
• Fluconazole 800 mg daily for 2 weeks
• Then 400 mg daily for 8 weeks
• Then 200 mg daily, until her CD4 cell count has risen above 200 cells/mm3
• Note: fluconazole should not be used in the first trimester, unless it is used for the treatment of cryptococcal
meningitis.
11. ART AND PREVENTION OF MOTHER-TO-CHILD TRANSMISSION (PMTCT)
• All HIV-infected pregnant women are offered lifelong ART, irrespective of CD4 count or HIV disease stage.
• ART regimens
1. The first-line regimen comprises a fixed dose combination (FDC) tablet containing:
2. Tenofovir (TDF) 300 mg, Emtricitabine (FTC) 200 mg, and Efavirenz (EFV) 600 mg, taken once at night
3. Alternative ART regimens include Abacavir (ABC) in place of TDF for women with renal dysfunction (serum
creatinine >85 μmol/L)
4. Nevirapine (NVP) in place of EFV for women with active psychiatric illness, provided her CD4 <250 cells/mm3 OR
5. Lopinavir/ritonavir (LPV/r) if her CD4 ≥250 cells/mm3
6. While NVP is rarely initiated in pregnancy because of the risk of life-threatening toxicity, women who become
pregnant on NVP and are stable on treatment may continue with NVP.
12. LABOUR AND DELIVERY
During labour for women who are unbooked & diagnosed HIV positive:
1. Give single-dose NVP 200 mg orally at onset of labour
2. Give single-dose TDF 300 mg with FTC 200 mg orally at onset of labour
3. Give AZT 300 mg 3 hourly orally
4. Commence lifelong ART within 24 hours after delivery
13. HIV PREVENTION AND TESTING FOR INFANTS
• All HIV-exposed infants, regardless of infant feeding method
and whether the mother is on ART or not, should receive
daily NVP syrup for the first 6 weeks of life.
• NVP syrup is stopped at 6 weeks in formula fed infants. It is
also stopped at 6 weeks if the infant is breastfed and the
mother is on ART.
• All HIV-exposed infants must have an HIV PCR test done at
birth, and again at 10 weeks of age, and, if positive, must be
referred for ART initiation immediately.
• . All HIV-exposed infants who tested negative previously
must have an HIV antibody test at 18 months.
Infant’s age Nevirapine syrup dose
Birth to weeks Birthweight <2500 g: 1.0 mL (10 mg) daily
Birthweight ≥2500 g: 1.5 mL (15 mg) daily
14. ANTI-RETROVIRALS AND COMMON SIDE-EFFECTS
• Tenofovir (TDF): renal dysfunction, only use if serum creatinine <85 μmol/L
• Lamivudine (3TC) and Emtricitabine (FTC): side-effects not common, generally well-
tolerated
• Efavirenz (EFV): central nervous system effects – dizziness, insomnia, bad dreams, also
rash, hepatitis
• Abacavir (ABC): drug-induced hypersensitivity reaction (uncommon)
• Nevirapine (NVP): rash including Stevens-Johnson syndrome, hepatitis. Avoid NVP in
women with CD4 cell count >250 cells/mm3
• Lopinavir/ritonavir (LPV/r): diarrhea, nausea, dyslipidaemia
15. LABOUR AND DELIVERY
Labour is generally managed in the same way as for women who are HIV-negative.
1. Do not rupture membranes for poor progress unless her VL is undetectable
2. Avoid using penetrating fetal scalp electrodes for heart rate monitoring
3. Avoid episiotomy wherever possible
16. POSTPARTUM CARE
1. Give normal postpartum care, irrespective of mode of delivery
2. Inform the woman about handling and disposal of soiled pads and linen
3. Treat infections promptly and aggressively
4. Give information about advantages and disadvantages of breast and formula
feeding – strongly discourage mixed feeding
5. All HIV-positive women should be encouraged to exclusively breastfeed for the
first 6 months, with complementary feeding only from 6 months and
breastfeeding continued until 12 months, unless contraindicated
6. Give contraceptive advice and discuss sterilization if appropriate
17. WOMEN WITH ADVANCED HIV DISEASE
The following problems may be expected:
1. Opportunistic infections, e.g. meningitis, pneumonia, TB, chronic diarrhoea
2. Severe puerperal sepsis
3. Spontaneous preterm labour with or without chorio-amnionitis
4. The need for preterm elective delivery in a terminally ill pregnant woman – requires a
discussion with the family
5. Rapid deterioration and death after delivery, especially after spontaneous preterm labour
6. Possible need for disclosure of the illness to the relatives
7. Treatment is individualized according to each patient’s specific disease profile and family
circumstances.
18. HIV INFECTED NOT ON ART
WHO STAGING, SCREEN FOR TB,
TAKE BLOOD FOR CD4,
CREATININE
• No history of psychiatric
or renal disease
Start FDC the same day
(TDF/FTC/EFV)
One week later
CD4 and creatinine
results
History of renal disease
Creatinine ≤85 Creatinine >85 ABC + 3TC + EFV
Investigate for renal disease
Continue FDC as lifelong ART
LIFELONG ART FOR ALL HIV-INFECTED PREGNANT & BREASTFEEDING WOMEN
19. RFERENCES
1. Latest obstetrics 2017 protocol book , p 129-135
2. Brinkman K, ter Hofstede HJ, Burger DM, Smeitink JA, Koopmans PP. Adverse
effects of reverse transcriptase inhibitors: mitochondrial toxicity as common
pathway. AIDS. 1998 Oct 1. 12(14):1735-44
3. French R, Brocklehurst P. The effect of pregnancy on survival in women
infected with HIV: a systematic review of the literature and meta-analysis. Br J
Obstet Gynaecol. 1998 Aug. 105(8):827-35