Question

Prevention of mother to child transmission of HIV infection

Hint:

Providing ART to both HIV-positive mothers and their infants significantly reduces the risk of mother-to-child HIV transmission.

Answer 1

Step 1: Understanding mother-to-child transmission of HIV (MTCT).
Mother-to-child transmission (MTCT) of HIV can occur during pregnancy, labor, delivery, or breastfeeding. The risk of transmission is higher if the mother has a high viral load or if she is not on antiretroviral therapy (ART). Preventing MTCT is crucial to reducing the number of children born with HIV.

Step 2: Strategies for prevention.
- Antiretroviral Therapy (ART): The most effective method of preventing MTCT is to administer ART to HIV-positive mothers during pregnancy, labor, and delivery. ART reduces maternal viral load and minimizes the risk of transmission.
- Scheduled Cesarean Section: For mothers with a high viral load or unknown HIV status at the time of labor, cesarean delivery can reduce the risk of transmission, especially when ART is not optimally controlled.
- Postnatal ART for Infants: Infants born to HIV-positive mothers should receive antiretroviral prophylaxis for 4-6 weeks after birth to further reduce the risk of transmission.
- Avoidance of Breastfeeding: In high-income countries where safe alternatives are available, breastfeeding should be avoided as HIV can be transmitted through breast milk. In resource-limited settings, exclusive breastfeeding for the first 6 months with ART can reduce the risk of transmission.

Step 3: Conclusion.
The key to preventing MTCT of HIV is early diagnosis, appropriate ART during pregnancy, and postnatal care for both the mother and child. Early intervention is crucial to preventing HIV transmission.