Which drug is given to prevent HIV transmission from mother to child:
Correct Answer: Nevirapine
Description: Ans. is a, i.e. NevirapineRef Dutta Obs. 7/e, p 301, 302, Current concept in contraception and women health, p 186, 188: Shiela balakrishnan/text book of Obs p 360; Williams Obs. 23/e, p 1252: Harrison 17/e, p 1145Traditionally the therapy being given to prevent fetomaternal transmission of HIV has been zidovudine.But the cost of the therapy makes it out of reach of many patients in the developing countries.One important study in Uganda demonstrated that a single dose of nevirapine given to the mother at the onset of labour followed by a single dose to the new born within 72 hours of birth decreased transmission by 50% compared with a regimen of zidovudine to the mother.The cost of this regimen is much cheaper than that of zidovudine and thus is being used increasingly in developing countries for prevention of mother to child transmission.According to Harrison 17/e, p 1145Zidovudine treatment of HIV infected pregnant women from the begining of 2nd trimester through delivery and of infant for 6 weeks following birth dramatically decreased the rate of intrapartum and perinatal transmission of HIV infection from 22.6% in the untreated group to 5%.It further says "Short course prophylactic antiretroviral (ARV) regimens, such as single dose of nevirapine given to the mother at the onset of labour and a single dose of nevirapine to the infant within 72 hrs of birth are of particular relevance to low-to-mid income nations because of the low cost and the fact that in these regions, perinatal care is often not available and pregnant women are often seen by a health care provider for the first time at or near the time of delivery."Note:These days when a pregnant female presents with HIV in pregnancy-HAART, i.e combination of three or four drugs from at least two different classes, is given to all pregnant female with HIV, irrespective of CD4 count or viral loadIf a woman on HAART gets pregnant, her HAART is continued during pregnancyHAART reduces the chances of vertical transmission by less than 2%Zidovudine is given IV during labor and delivery to woman with HIV RNA viral load more than 400 copies per mL or who have unknown viral load near delivery
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Gynaecology & Obstetrics
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