Under the Prevention of Parent to Child Transmission of HIV (PPTCT) component of NACP, a pregnant woman is diagnosed HIV positive at her first antenatal visit. The recommended approach is:

• A Initiate lifelong triple-drug antiretroviral therapy regardless of CD4 count ✓
• B Start zidovudine monotherapy and reassess after delivery based on viral load
• C Defer ART until the second trimester to avoid teratogenicity
• D Advise elective caesarean section as the sole intervention

Explanation

Following the Treat All policy, every HIV-positive pregnant woman is started on lifelong triple-drug ART, typically tenofovir, lamivudine and efavirenz, at diagnosis irrespective of CD4 count or clinical stage, and continues it after delivery. Zidovudine monotherapy is obsolete and insufficient for viral suppression. Modern ART regimens are safe throughout pregnancy, so delaying treatment increases vertical transmission risk. Caesarean section is not the mainstay when the mother is virally suppressed on ART.

Reference: National Guidelines for Prevention of Parent to Child Transmission of HIV, NACO, 2021 update ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.