ARV prophylaxis for the HIV exposed infant

• All HIV exposed infants should receive ARV prophylaxis regardless whether they are being breastfeed or receiving replacement feed.

• Infants born to mothers with HIV who are at high risk of acquiring HIV should receive dual prophylaxis with AZT (bd) and NVP (od) for the first 6 weeks of life, whether they are breastfed or formula fed. 

• Infants delivered to HIV positive mothers who are stable on ART should receive NVP prophylaxis. These infants irrespective of the type of feeding should receive daily NVP from within 72 hours of birth to 6 weeks of age. 

• If infants are receiving replacement feeding, they should be given 4 to 6 weeks of infant prophylaxis with daily NVP (or AZT bd). (When NVP is not available and AZT has to be used, HB should be monitored closely for early detection of anaemia.) 

• For babies with weight <2,5kg, give NVP 10mg or 1ml once daily 

•  For babies with weight ≥2, 5kg, give NVP 15mg or 1.5ml once daily. 

Special situations for extended ARV prophylaxis for HIV exposed Infants at High Risk of MTCT

• Breastfed infants who are at high risk of acquiring HIV should continue infant prophylaxis for an additional 6 weeks (total of 12 weeks of infant prophylaxis) using AZT (twice daily) and NVP (once daily). 

• High-risk infants are defined as those: 

• Born to women with established HIV infection who have received less than four weeks of ART at the time of delivery 

OR

• Born to women with established HIV infection with viral load >1000 copies/mL in the four weeks before delivery, if viral load measurement available; 

OR

• Born to women with incident HIV infection during pregnancy or breastfeeding; 

OR

• Identified for the first time during the postpartum period, with or without a negative HIV test prenatally. 

Test Item – Discuss the causes and management of Danger signs during Pregnancy

STUDENTS’ ACTIVITY  

Topic: Antenatal Care (ANC)

Learning outcome

• Describe the 2 ANC models

• Identify the procedures carried out in the general ANC clinic

• Describe the ANC contacts and what they entails

• Discuss the danger signs in pregnancy and how to manage them

• Discuss the Elimination of Mother to Child Transmission of HIV Infection

Task: Use role play to demonstrate how to provide routine ANC services for a well pregnant woman and a pregnant woman with danger signs