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Prevention of Mother-to-Child Transmission of HIV Infection - Essay Example

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Infection of HIV in a child from a HIV positive mother, either during pregnancy, or during labor or during breast feeding, is known as mother-to-child transmission (MTCT) (WHO, 2008). This is also known as perinatal transmission. Infact, it is the most common cause of HIV infection among children less than 15 years of age (Kapoor, p.247)…
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Prevention of Mother-to-Child Transmission of HIV Infection
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Download file to see previous pages This method of prevention involves education about HIV in the society, safe-sex practices, avoiding sharing of contaminated needles for intravenous drugs. Proper moral behavior is necessary to follow these norms (Kapoor, p.248).
3. Prevention of transmission of HIV infection from infected mothers to their babies by anti-retroviral therapy. This therapy is instituted both to the pregnant mother and also to the baby after delivery. Transmission of infection is also prevented by avoiding breast feeding (Kapoor, p.248).
All pregnant women attending antenatal clinics during pregnancy should be counseled about HIV infection. They should be educated about the disease and the modes of transmission. The women should be encouraged to take up HIV test voluntarily. They should be informed about the importance and implications of the test and also the course of management if found positive. Women with high-risk behavior should be advised about window period and repetition of the test after 3-6 months if the HIV test is negative (Kapoor, p.248). Any woman who is found to be HIV positive should be taken into confidentiality and counseled appropriately. She should be motivated, be taught 'positive thinking' and informed that 'HIV is not AIDS'. She should also be warned against transmission of the disease to others and how to prevent it by following simple steps like using condoms. The option of termination or continuation of pregnancy should be left to her, but she must be advised about antiretroviral therapy for the baby if she decides to continue the pregnancy (Kapoor, p.248).
Anti-Retroviral Therapy (ARV)
Administration of ARV to the HIV positive pregnant mother decreases the risk of MTCT by reducing the viral load in the mother and also by preventing fixing of the virus in the baby (Kapoor, p.248). Monotherapy with zidovudine causes only suboptimal suppression. Hence it is recommended to use optimal combination of anti-retroviral drugs as is used in non-pregnant women (Chen, p.1616). The treatment currently used in the treatment of adults with HIV infection is 'highly active antiretroviral therapy' (HAART) (Chen, p.1616). It consists of a protease inhibitor or a nonnucleoside reverse-transcriptase inhibitor (NNRTI) such as efavirenz and two nucleoside reverse-transcriptase inhibitors (NRTIs). However, this treatment should be instituted only after 10-12 weeks of gestation to prevent teratogenic effects. All infants born to HIV positive mothers and having received ARV should be followed up long-term irrespective of their HIV status (Chen, p.1616).
Nevirapine (NVP) for Prevention of MTCT
NVP is a NNRTI. It directly binds to the HIV-1 reverse transcriptase, inhibits the synthesis of viral DNA and thus inhibits the viral replication. After a single dose of 200 mg to the mother, it crosses the placenta efficiently. Added to this advantage, it has a long half-life of 40 hours (Kapoor, p.249). In neonates and infants, the dose is 2mg/kg (Kapoor, p.249). The advantage of NVP therapy is that the administration is a simple two-dose regimen to be taken by mouth. Also, it is inexpensive, easier to maintain confidentiality, does not ...Download file to see next pagesRead More
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