HIV_Flashcards
What are the antenatal care steps for a pregnant woman with HIV?
Arrange contact with a joint HIV physician and obstetric clinic every 1-2 weeks.
What monitoring is required for a pregnant woman with HIV?
Monitor CD4 counts at baseline and at delivery, and HIV viral load every 2-4 weeks, at 36 weeks’ gestation, and at delivery.
What is the recommendation for ART in pregnant women with HIV?
All women should be offered ART regardless of whether they were taking it pre-conception.
What should be offered if a woman with HIV refuses ART despite counselling?
If a woman refuses ART despite counselling and explanation, zidovudine monotherapy can be offered (if CD4 >350 and viral load <10,000). Delivery must be via C-section with a zidovudine infusion running.
How does the mode of delivery depend on the viral load at 36 weeks’ gestation?
If the viral load is <50 copies/mL at 36 weeks, vaginal delivery can be offered. If the viral load is >50 copies/mL or there is co-existent hepatitis C, recommend elective C-section with intrapartum IV zidovudine.
What should be done immediately after the baby is born to a mother with HIV?
The cord should be clamped as soon as possible, and the baby should be bathed immediately after birth.
What is the postnatal advice for women with HIV regarding breastfeeding?
Advise women not to breastfeed. This advice is specific to women in the UK.
What is the postnatal treatment for newborns exposed to HIV?
Treat all newborns with ART within 4 hours of birth. Low-risk of transmission: zidovudine monotherapy for 2-4 weeks. High-risk of transmission: triple ART (zidovudine, lamivudine, and nevirapine) for 4 weeks.
How is the diagnosis of HIV in the neonate confirmed or denied?
Confirm or deny the diagnosis of HIV in the neonate with direct viral amplification by PCR (normally carried out at birth, on discharge, at 6 weeks, and at 6 months).
