ch04 hiv
DESCRIPTION
gfdTRANSCRIPT
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7/21/2019 CH04 HIV
1/19
Infectio
nInternational
PREVENTION OF MATERNAL
TO CHILD TRANSMISSION OF
HIV
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7/21/2019 CH04 HIV
2/19
Infectio
nInternational
Objectives
Describe relationship of HIV on
pregnancy
Factors affecting vertical transmission
Strategies to prevent maternal to child
transmission
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7/21/2019 CH04 HIV
3/19
Infectio
nInternational
Introduction
U!IDS about "# million adults$
children living %ith HIV&!IDS in Sub
Saharan !frica' (million ne% cases yearly
)**+*** to ,**+*** !IDS related
deaths in -... in children /* 0-(yrs1
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7/21/2019 CH04 HIV
4/19
Infectio
nInternational
HIV AND PREGNANCY
2ffect of pregnancy on HIV progression
2ffect of HIV on pregnancy outcome
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7/21/2019 CH04 HIV
5/19
Infectio
nInternational
Effects of pregnancy on HIV
nfecton
o effect on HIV progression'
Slight decline in absolute numbers of 3D(
count / 4 of 3D( cells remains stable
o overall significant in deaths rate
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7/21/2019 CH04 HIV
6/19
Infectio
nInternational
Effect of HIV on pregnancy
co!rse an" o!tco#e
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7/21/2019 CH04 HIV
7/19
Infectio
nInternational Materna$ to C%$"
Trans#sson !ccounts to -# 4 of all transmission in Uganda
!ccounts for 5 .*4 of infection in children
In !frica rate of 6737 is "* 0(*4 Overall ris8 at point estimate for transmission
During pregnancy9 # 0-*4
In labour9 -# 0"*4
:reast feeding 9 -*0-#4
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7/21/2019 CH04 HIV
8/19
Infectio
nInternational
Factors affecting transmission
Viral factors9
/;oad+strain variation1rovision of @uality !30"&st Vst'Detailed history+ e=amination+ investigation+
folic supplements+de%orming and V337
(r" Vst'6onitor progress of pregnancy+ 3ounsel on
pmtct and breast feeding option+ -st dose of
I>7+tetanus to=oid+iron&folic supplementation'
)r" Vst'6onitor progress of pregnancy+blood pressure
+Hb and urine analysis+"rd dose I>7+tetanus to=oid+
iron&folic supplementation'3ounseling support
*t% Vst'!s above' 2nrolment on the >6737
program+Bive antiretroviral drugs
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7/21/2019 CH04 HIV
13/19
Infectio
nInternational
Health education
utrition+personal hygiene+environmental sanitation
ormal 7etanus to=oid schedule
S7I treatment :enefits of V337
3ondom usage and family planning
6ale involvement
:reast feeding &other feeding options
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7/21/2019 CH04 HIV
14/19
Infectio
nInternational !30(
&+Mcro,n!trent s!pp$e#ents
(+Pre-enton . treat#ent of nfectons
Intermittent presumptive treatment9 ) dosesof S>
identification$ treatment of S7I
)'Ant retro-ra$ treat#ent !C7
everapine
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7/21/2019 CH04 HIV
15/19
Infectio
nInternational 3are during ;abour and
Delivery&+ Bood Obstetric practice
"' !nte retroviral drugs
)' 6odified Obstetric practice Delay !A6
23V
Aoutine episiotomies
Instrumental deliveries
7raumatic suction of child
Universal precautions'
(' 6ode of delivery
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7/21/2019 CH04 HIV
16/19
Infectio
nInternational
Short course anti0retroviral
treatment
Options9
!C7 after ), %ee8s antepartum+intrapartum
amd post partum %ith neonatal treatment for
days' /4Aeduction #*41 at E%ee8s
evirapine In labour and neonatal treatmentfor (E to " hours' /4 reduction (41 at E
%ee8s
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7/21/2019 CH04 HIV
17/19
Infectio
nInternational
Oral !nti retroviral treatment
Antepart!# Intrapart!# Post part!#For mother
neonata$
-'A/T)**mgs
p'o :'D after )#%ee8sgestation
A/T)**mgs p'o
)hourly tilldelivery
A/T)**mgs p'o
:'D for days(mgs&8g p'o :'Dfor days
"' one NVP"** mgs p'pat onset of labour
none "mgs&8g p'o (E0" hours
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7/21/2019 CH04 HIV
18/19
Infectio
nInternational
>ost natal care
Dual use of 3ontraception/ :arrier$
contraception1'
Ongoing 3are
3ounseling and support
3are of the eonate+/2=clusive breast
feeding for )&-" months or !rtificial
infant feeding1
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7/21/2019 CH04 HIV
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Infectio
nInternational
3onclusion
6aternal to child transmission can be
reduced by #*4
2ffective counseling +support+treatment
of opportunistic infections and anti
retroviral treatment can improve ?ualityof life'