A 26-year-old pregnant woman attending her first antenatal visit is screened for HIV and tests positive. Her CD4 count is 520 cells/mm3. According to the current National AIDS Control Organisation PPTCT guidelines, the correct management of this woman is:
- A Withhold antiretroviral therapy and give single-dose nevirapine at onset of labour
- B Start lifelong triple-drug antiretroviral therapy irrespective of CD4 count ✓
- C Start zidovudine monotherapy now and switch to triple therapy after delivery
- D Defer antiretroviral therapy and repeat CD4 count at 34 weeks of gestation
Correct answer: B. Start lifelong triple-drug antiretroviral therapy irrespective of CD4 count
Explanation
India follows the WHO Option B+ approach: every HIV-positive pregnant or breastfeeding woman is started on lifelong triple-drug ART (currently tenofovir-lamivudine-dolutegravir) at diagnosis, regardless of CD4 count, both for her own health and for prevention of vertical transmission. Single-dose nevirapine at labour was abandoned years ago because it selects for resistant virus, so option A is the classic obsolete answer that examiners use as a distractor.
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.