Regarding transmission of HIV to infant from infected HIV mother, which statement is/are true:a) Start zidovudine during labour.b) 25% chance of vertical transmissionc) Avoid breast feedingd) Vaccinate infant with OPV and MMRe) Cesarean section cause less transmission
**Core Concept**
The transmission of HIV from an infected mother to her infant is a significant concern in maternal-child health. Vertical transmission occurs through the placenta during pregnancy, during delivery, or through breastfeeding.
**Why the Correct Answer is Right**
The correct approach to reducing HIV transmission involves a multi-faceted strategy. Administering zidovudine (AZT) to the mother during labor and to the infant after birth significantly reduces the risk of vertical transmission. The risk of transmission is indeed around 25% without intervention, highlighting the importance of prophylaxis. Breastfeeding is a significant risk factor for transmission, and avoiding it is crucial. The OPV (oral poliovirus vaccine) and MMR (measles, mumps, and rubella) vaccines can be safely administered to HIV-exposed infants. Cesarean section may reduce the risk of transmission, but it is not a guarantee and should be considered on a case-by-case basis.
**Why Each Wrong Option is Incorrect**
**Option A:** Zidovudine should be started during pregnancy, not just labor, to maximize its effectiveness. Starting it only during labor may not be sufficient.
**Option B:** This statement is incorrect because the risk of vertical transmission is around 25% without intervention, but with proper prophylaxis, the risk can be significantly reduced.
**Option C:** While breastfeeding does pose a risk for transmission, it is not the only risk factor and is often necessary for infant nutrition in resource-limited settings. However, safe alternatives to breastfeeding should be provided when possible.
**Option D:** While OPV and MMR vaccines are safe for HIV-exposed infants, the statement is incomplete as it does not mention the need for careful consideration and monitoring by healthcare providers.
**Clinical Pearl / High-Yield Fact**
When caring for HIV-exposed infants, it is essential to remember that the risk of transmission can be significantly reduced with proper prophylaxis and precautions, but not eliminated. Close monitoring and follow-up are crucial to ensure the infant's health and well-being.
**Correct Answer:** C. Avoid breast feeding