HIV母婴传播与阻断.ppt

* * * * * * Azt 300 bid, 3tc 150mg bid, and NVP 200 mg bid * * Recommended regimen: highly effective regimen, substantially reduces in utero transmission, maternal azt/3tc “tail” may reduce the development of maternal resistance, infant azt reduces risk of nvp resistance Alternative: higher risk of developing NVP resistance because of the single dose. * * * * RECOMMENDED: Advantages: SD-NVP effective at reducing MTCT by ~40%, tail will reduces the development of maternal resistance, and infant azt will also reduce the risk of infant NVP resistance; Disadvnatages: more complex, unclear if 4 weeks has added benefit Alternative, advantages no risk of NVP resistance Minumum: SD-NVP effective at reducing MTCT by ~40%, tail reduces development of maternal NVP resistance * * * * Alternative is better than minimum * * * * * * * * * * * * * 1. HIV infected pregnant women who neither had indications for ART nor received any ARVs in the past ? (1) Recommended regimen During Pregnancy: AZT 300mg po bid from the 28th week of pregnancy (or as early as possible after 28th week of pregnancy) until delivery. AZT 300mg po q3h, NVP 200mg and 3TC 150mg; then AZT 300 mg q3h and 3TC 150mg q12h until the labor ends Postpartum: continue to take AZT 300mg and 3TC 150mg po bid for one week ? Neonates born to HIV infected mothers: NVP 2mg/kg single dose (or syrup 0.2ml/kg) (maximum dose 6mg, or syrup 0.6ml) as early as possible after birth; and AZT 4mg/kg (or syrup 0.4ml/kg) q12h for one week. If the mother has taken ARVs for less than four weeks, the neonate should continuously take AZT for four weeks. As for women who did not test positive during pregnancy, ARVs should also be used from labor afterward according to the recommended regimen. As for women who tested positive after delivery, she could be held from using ARVs for the moment, but the infant should use NVP single dose and AZT for four weeks as soon as possible, the dosage and administration comply with the recommended reg