AZTplussdNVP.pptVIP

OBJECTIVES: To understand the role of antiretroviral in prevention of mother to child transmission of HIV To understand the rationale behind the new guidelines To know about the new WHO guidelines on use of antiretroviral in prevention of mother to child transmission of HIV(PMTCT) To be able to select appropriate interventions for prevention of MTCT of HIV Timing of MTCT HIV-1 transmission can occur during intrauterine, intrapartum, and post-partum period. The estimates of timing of vertical transmission differ between breast-feeding and non-breast-feeding population. Various studies have shown that the estimates for intrauterine, intrapartum, and postpartum period as ranging between 23-30 %, 45-50%, and 30-35 % among breast-feeding population The efficiency of MTCT of HIV-2 was reported to be 1.2% when compared to 24.7 % of HIV?1 that is almost 20 times lesser than that of HIV-1.. NNRTI’s such as Nevirapine is not effective against reducing the risk of transmission of HIV-2. In breastfeeding populations, up to 44% of the infections can be attributed to breastfeeding, depending on the duration of breastfeeding and through risk factors such as presence of mastitis, breast abscess and other local factors. Comprehensive approach to prevent HIV infection in infants Prevention of HIV in parents to be Efficacy of AZT alone or AZT/3TC regimens decreases with breastfeeding, particularly with prolonged breastfeeding In contrast, efficacy of sd-NVP less affected by breastfeeding A combination regimen of AZT plus sd NVP is more effective than single drug regimens in formula-fed and breastfeeding populations AZT plus sd NVP is equally effective as a more complex regimen of AZT/3TC + sd NVP and an AP-IP-PP regimen of AZT/3TC Estimated 20-30% of pregnant women meet WHO criteria for initiating ART for their own health Advanced disease, low CD4 are associated with higher MTCT, even in women receiving short-course ARV prophylaxis Risk of NVP resistance after sd-NVP, given a