A 26-year-old woman attending an antenatal clinic is diagnosed HIV-positive with a CD4 count of 520 cells/cumm. Under the current PPTCT strategy of NACP, the correct management of her pregnancy is:

• A Lifelong antiretroviral therapy started immediately, irrespective of CD4 count ✓
• B Zidovudine monotherapy started at 28 weeks until delivery
• C Short-course dual ARV prophylaxis continued only through breastfeeding, then stopped
• D Defer therapy until CD4 falls below 350 cells/cumm

Explanation

India adopted Option A Plus in its PPTCT programme: all pregnant and breastfeeding women living with HIV receive lifelong triple-drug ART regardless of CD4 count, currently a TLD-based regimen. Zidovudine monotherapy and short-course prophylaxis were abandoned because they left mothers unprotected outside pregnancy and allowed vertical transmission during breastfeeding. Starting ART only when CD4 drops is the old 'test and treat by threshold' approach, replaced nationally since 2013.

Reference: Park's Textbook of Preventive and Social Medicine, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.