In 2015, the World Health Organisation (WHO) released new guidelines on the use of antiretroviral drugs (ARVs) for treating and preventing HIV infection.
The guidelines include recommendations for providing lifelong antiretroviral treatment (ART) to all pregnant and breastfeeding women living with HIV for the prevention of mother-to-child transmission (PMTCT).
Guidelines for pregnant and breastfeeding women and mothers living with HIV
The WHO 2015 guidelines recommend that programmers follow Option B+ for PMTCT. Option B+ recommends providing lifelong ART to all pregnant and breastfeeding women living with HIV regardless of CD4 count or WHO clinical stage. ART should be maintained after delivery and completion of breastfeeding for life.
Previously, the 2013 guidelines contained another choice called Option B, whereby treatment was only continued after the completion of breastfeeding, if the mother was eligible for ART for her own health. The 2015 guidelines no longer recommend this option.
Guidelines for HIV-exposed infants
All infants born to HIV-positive mothers should receive a course of medication linked to the ARV drug regimen that the mother is taking and the infants feeding method.
The infant should receive once-daily nevirapine (NVP) from birth for six weeks.
- Replacement feeding
The infant should receive once-daily NVP (or twice-daily zidovudine (AZT)) from birth for four to six weeks.
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