This flowchart outlines the protocol for preventing mother-to-child transmission (PMTCT) of HIV and postnatal care for both mother and infant. It indicates that HIV-positive mothers should start antiretroviral therapy (ART) immediately, with follow up creatinine testing and potential switching of medications. Mothers receive adherence counseling, CD4 and creatinine testing, and are monitored until the end of breastfeeding. Infants receive nevirapine prophylaxis depending on the mother's HIV and ART status, with follow up rapid testing for infants at 6 weeks or older.
This flowchart outlines the protocol for preventing mother-to-child transmission (PMTCT) of HIV and postnatal care for both mother and infant. It indicates that HIV-positive mothers should start antiretroviral therapy (ART) immediately, with follow up creatinine testing and potential switching of medications. Mothers receive adherence counseling, CD4 and creatinine testing, and are monitored until the end of breastfeeding. Infants receive nevirapine prophylaxis depending on the mother's HIV and ART status, with follow up rapid testing for infants at 6 weeks or older.
This flowchart outlines the protocol for preventing mother-to-child transmission (PMTCT) of HIV and postnatal care for both mother and infant. It indicates that HIV-positive mothers should start antiretroviral therapy (ART) immediately, with follow up creatinine testing and potential switching of medications. Mothers receive adherence counseling, CD4 and creatinine testing, and are monitored until the end of breastfeeding. Infants receive nevirapine prophylaxis depending on the mother's HIV and ART status, with follow up rapid testing for infants at 6 weeks or older.
This flowchart outlines the protocol for preventing mother-to-child transmission (PMTCT) of HIV and postnatal care for both mother and infant. It indicates that HIV-positive mothers should start antiretroviral therapy (ART) immediately, with follow up creatinine testing and potential switching of medications. Mothers receive adherence counseling, CD4 and creatinine testing, and are monitored until the end of breastfeeding. Infants receive nevirapine prophylaxis depending on the mother's HIV and ART status, with follow up rapid testing for infants at 6 weeks or older.
Start ART immediately: FDC ** After 1 week, if Creatinine
> 85moll/l swithc to AZT **see clinical guidelines for maternal regimens Ask about risk: Unprotected sex / intravenous drug users/ STIs Retest mother at 6 week post natal visit and then every 3 months until end of breastfeeding Begin Adherence counselling / nutrition counselling / CD4 test / stage patient Advise women to come to clinic when they STOP BREASTFEEDING to do CD4 test Phone patient to arrange clinic visit to discuss CD4 result within 1 week HIV POSITIVE mother: Do CD4 and Creatinine tests See Adult Algorithm IF CD4 350 or stage III / IV continue lifelong ART IF CD4 >350 and breastfeeding has stopped, enroll mother in wellness program HIV NEGATIVE mother IF POSITIVE POST NATAL IF POSITIVE Re-test every 3 months until delivery At 6 weeks do HIV PCR test at the 6 week EPI visit Post Natal Care for Infants HIV+ Mother on ART: Infant gets NVP at birth and then daily for 6 weeks See clinical guidelines for infant dosing protocol Immediately begin on ART Unknown maternal status / abandoned / orphaned: Start NVP immediately then do HIV antibody test. If positive continue NVP, if negative stop NVP Do HIV rapid test 6 weeks after last day of breast feeding or at >18 months HIV+ Mother who did not get ARVs before or during delivery: NVP ASAP and daily for 6 weeks POSITIVE NEGATIVE IF POSITIVE