2016 sessions: pmtct of hiv
TRANSCRIPT
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