HIV and Pregnancy

Question 1

When should ART be initiated in Pregnancy

Answer 1

At beginning of second trimester is VL 30-000-100 000 copies and at sometime during the second trimester if <30,000 copies/ml

Question 2

What are the main conditions for supporting breastfeeding

Answer 2

Undetectable viral load
Good adherence to ART
Mother and Infant viral load monthly during and for two months after breast feeding

Question 3

What is the vertical transmission risk in women with a VL <50 copies/ml

Answer 3

<0.5%

Question 4

Infant PEP

Answer 4

Start within 4 hours of birth
Zidovudine
Duration depends on having two undetectable VL 4 week apart with one being at 36 weeks onwards

Question 5

Fourth generation HIV testing in infants to mother living with HIV

Answer 5

Can remain positive for up to two years

Question 6

Infant testing timing

Answer 6

Within 48hours of birth at 6 weeks, 12 weeks and 18-24 months

Question 7

Do not delay cervical screening and colposcopy in the following risk groups

Answer 7

CIN 2 or 3 with loss to follow up
Or cervical glandular intraepithelial neoplasia