A 26-year-old antenatal woman at 16 weeks of gestation is found HIV reactive on confirmatory testing. As per national PPTCT guidelines, the correct management is:

• A Defer ART until CD4 count falls below 350 cells per mm3
• B Start lifelong antiretroviral therapy regardless of CD4 count ✓
• C Give single-dose nevirapine at the onset of labour only
• D Advise medical termination of pregnancy to prevent vertical transmission

Explanation

India adopted the Option A+ policy: every pregnant woman living with HIV is started on lifelong triple-drug ART, currently tenofovir-lamivudine-dolutegravir, irrespective of CD4 count, continued for life. Single-dose nevirapine in labour was the older short-course approach associated with resistance and incomplete suppression, and termination advice contradicts the programme goal of eliminating parent-to-child transmission.

Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.