PREVENTION OF MOTHER TO CHILD TRANSMISSION OF HIV

DR P S ALLANCONSULTANT PHYSICIAN ASSOCIATE PROFESSOR

WARWICK MEDICAL SCHOOL

Background, risk of transmission

Screening for HIV

Management of HIV Positive and Negative Mothers:

• Antenatal

• Labour

• Post Natal

• Neonatal

Organisational Structure

Take Home Message

BACKGROUND:

Risk of Transmission – about 1/3 (22-45%)

• Antenatal – 2%

• Labour – 80%

• Post Natal, breast feeding – 18%

Chronic HIV Infection

Acute, sero-conversion – PregnancyBreast feeding period

High Risk Group

Contact Tracing

High risk partner – How to manage

MANAGEMENT:

Antenatal

• HAART

• When to start

• What to start with

• 3 Drug combination-HAART

• Zidovudine Monotherapy

- Viral Load Management

Labour – Foetal monitoring - during labour- IV Zidovudine

Post Natal – HAART

• Breast feeding

• Bottle feeding

Neonatal Management:

• Zidovudine

• HAART

• Vaccination, BCG

Organisational Structure:

• HIV Physician/Clinical Nurses

• Obstetricians/Midwives

• Paediatricians/Specialist Neonatal Nurses

• Virologist

• Health Advisors

Take Home Message:

1. Screening

2. Medical Management

3. MDT Approach

Thank you