1-Is this baby infected with HIV?
Mother-to-child transmission (MTCT) is when an HIV positive woman passes the virus to her baby. This can occur during pregnancy, labour and delivery, or breastfeeding. Without treatment, around 15-30% of babies born to HIV positive women will become infected with
HIV during pregnancy and delivery. A further 5-20% will become infected through breastfeeding.
This means this baby has 20-50% to be HIV infected. Therefore we can predict it what are his chances of being infected, but can only be confirmed by HIV test.
2- How do you know?
Because positive antibody results alone do not establish infection in children younger than 18 months of age, therefore Children who are younger than 18 months of age and are born to an HIV-infected mother is best to use one of the following methods:
• HIV DNA PCR (preferred method)
• HIV culture (acceptable method)
Because infection can only be confirmed with two positive test results performed on samples collected at different times, a repeat sample should be obtained promptly for any child with a single positive test result.
In an infant younger than 18 months of age, HIV can be reasonably excluded with two negative HIV viral tests, one at 1 month of age or older, and the other at age 4 months or older.
Ideally, a DNA PCR should be obtained for HIV-exposed infants at each of the following time points:
• at birth
• at 2 weeks of age
• at 4 to 6 weeks of age
• at 6 to 12 weeks of age
• at 4 to 6 months of age
3- How can one prevent infection of HIV from mother to baby?
Effective prevention of mother-to-child transmission (PMTCT) requires a three-fold strategy.
• Preventing HIV infection among prospective parents
• Avoiding unwanted pregnancies among HIV positive women
• Preventing the transmission of HIV from HIV positive mothers to their infants during pregnancy, labour, delivery and breastfeeding.
WHO guidelines for PMTCT drug regimens
Pregnancy Labour After birth: mother After birth: infant
Recommended AZT after 28 weeks single dose nevirapine; AZT+3TC for 7 days single dose nevirapine; AZT 7 days
AZT+3TC
Alternative higher
risk of drug resistance) AZT after 28 weeks single dose nevirapine single dose nevirapine; AZT 7 days
Minimum (less effective) single dose nevirapine; AZT+3TC for 7 days single dose nevirapine
AZT+3TC
Minimum
(less effective; single dose nevirapine single dose nevirapine
higher risk of drug resistance)
Caesarean sections
When a mother is HIV positive a caesarean section may be done to protect the baby from direct contact with her blood and other bodily fluids and is recommended if the mother has a high level of HIV in her blood. If the mother is taking combination antiretroviral therapy then a caesarean section will often not be recommended because the risk of HIV transmission will already be very low.
Breastfeeding
Mothers with HIV are advised not to breastfeed, other alternative should be used.
hope this is right answer
kassim