Hiv In Pregnancy

Question 1

What extra antenatal care is require?

Answer 1

None-routine antenatal care as per guidelines (no extra scans etc)

Question 2

Is delivery always by CS?

Answer 2

No (assuming no obs CI) aim Vaginal delivery if VL <50

50-400 grey area

> 400 recommend CS

Question 3

Any changes needed to ART meds in pregnancy?

Answer 3

Usually not if undetectable VL and happy.

However exceptions include: raltegravir dose switches from 1200mg od to 400mg bd

And cobicistat not effective.

Question 4

What support networks exist?

Answer 4

Mentor mothers-empower women to be involved in their care

Question 5

Can you breastfeed?

Answer 5

Officially no.

If women with undectable VL accept risk support to do so with frequent monitoring no more than 6/12

Question 6

What care will baby need after birth?

Answer 6

Meds for a few weeks (zidovudine if U VL)

HIV tests 0, 6, 12 weeks, 18-24mth (more often if BF)

Question 7

Postnatal care?

Answer 7

6/52 check including Contraception
Smear 3/12 PN then yearly

Question 8

What do you mean by CD4 count?

Answer 8

CD4 means a type of white blood cell. It is low in the blood when hiv infection is advanced

Question 9

What do you mean by viral load?

Answer 9

It is the amount of HIV in the blood

Question 10

What is hepatitis B?

Answer 10

A type of viral infection that affects the liver. It can be transmitted through bodily fluids such as blood, saliva, urine. Can pass mother to child.

Question 11

What is hepatitis C

Answer 11

A viral infection that affects the liver. It is spread via blood including shared needles, sex and can pass from mother to child.

Question 12

What is window period for HIV test?

Answer 12

4th gen serum 45 days
POCT up to 90 days