HIV and pregnancy

Question 1

Is HIV screening part of standard antenatal care?

Answer 1

Yes

All pregnant women should be screened for HIV at their booking visit (8-12 weeks)

Question 2

What treatment should HIV +ve pregnant women should be on?

Answer 2

ART
2 NRTIs and one of:
- integrase inhibitor
- NNRTI
- boosted protease inhibitor

Standard treatment is:
tenofovir disoproxil + emtricitabine + raltegravir

Question 3

What is the preferred mode of delivery for a HIV+ve woman with a viral load <50 copies/ml?

Answer 3

Vaginal delivery is recommended at ~36 weeks

i.e. same as non HIV +ve women

Question 4

What is the preferred mode of delivery for a HIV+ve woman with a viral load >50 copies/ml?

Answer 4

Caesarean section is strongly recommended

Question 5

What drug should be started prior to caesarean section, and when should it be started?

Answer 5

Zidovudine

Start 4h before c-section

Question 6

What should be given to the neonate following delivery?

Answer 6

• Viral load <50 copies/ml: zidovudine

- Viral load >50 copies/ml: triple ART

Question 7

How long should the neonate be treated for following delivery?

Answer 7

4-6 weeks

Question 8

Can HIV+ve women breastfeed?

Answer 8

Breastfeeding is not recommended for women who are HIV +ve