A 24-year-old primigravida at 16 weeks of gestation is diagnosed HIV positive at an ICTC. Her CD4 count is 480 cells/mm3 and she is asymptomatic. Under the current PPTCT strategy of NACP, what is the correct management?

• A Start lifelong triple-drug antiretroviral therapy immediately regardless of CD4 count ✓
• B Defer antiretroviral therapy until CD4 falls below 350 cells/mm3
• C Start zidovudine monotherapy now and switch to full ART after delivery
• D Give a single dose of nevirapine at onset of labour to the mother only

Explanation

India adopted the WHO Option B plus and later Test and Treat policies, so every pregnant woman diagnosed with HIV receives lifelong triple-drug ART irrespective of CD4 count or clinical stage. Zidovudine monotherapy and single-dose nevirapine are obsolete regimens associated with resistance, and deferring treatment until a low CD4 threshold contradicts the current treat-all policy that protects both mother and infant.

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.