Question

Vertical transmission of HIV is highest with

• A. Elective caesarean section
• B. High viral RNA load
• C. Breast feeding
• D. Term delivery

Answer 1

The Correct Option is B

Vertical transmission of HIV, which refers to the transmission of the virus from a mother to her child during the period immediately before and after birth, is influenced by several factors. Among the provided options, High viral RNA load is the factor that most significantly increases the risk of vertical transmission.

• High viral RNA load: The viral load, which measures the quantity of HIV RNA in the blood, is a critical factor in determining the risk of transmission. A high viral load indicates active replication of the virus and a greater quantity of the virus in bodily fluids, increasing the likelihood of the virus crossing the placental barrier or being transmitted during delivery.
• Elective caesarean section: Performing an elective caesarean section can reduce the risk of transmission, particularly if done before labor starts and before the membranes rupture.
• Breast feeding: Breastfeeding contributes to postnatal transmission of HIV due to the presence of the virus in breast milk, but it is not the single highest risk factor when compared to viral load.
• Term delivery: The timing of delivery itself (at term versus preterm) is less significant than the viral load in determining transmission risk.

In conclusion, maintaining a low viral load through antiretroviral therapy is crucial for reducing the risk of vertical transmission of HIV from mother to child.