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Facts of MTCT
Highest risk of transmission is during labour, in early & late stage disease.
TIMING OF MTCT
In Utero 15 - 20%
Breastfeeding 15 - 20%
PMTCT
Provision of treatment, care & support to HIV+ women, their infants & families
Use of ITNs
Nutrition
Septrin therapy
ARV therapy
OPTION A
This included: women with CD4<350 or stage 3 -4, eligible for treatment, women with
CD4>350, AZT at 28 weeks, SD-NVP + AZT + 3TC intra-partum and seven days post partum of
maternal AZT+3TC, infant received 6 weeks of AZT or NVP, no extended breastfeeding
prophylaxis
Option B recommends AZT+3TC at 14 weeks for mother diagnosed to be HIV positive, a triple
ARV treatment until one week after end of breastfeeding for use as prophylaxis to prevent
mother-to-child transmission of HIV.
Attaining success across all four prongs of PMTCT will be required to effectively scale up
programs to eliminate MTCT.
This assertion by the WHO is a critical contribution to our effort to optimize our efficiency in
delivery of services to virtually eliminate MTCT
To Eliminate Mother To Child Transmission (EMTCT) Of HIV By 2015 the World Health
Organization (WHO) asserted, “Options B and specifically B+ are likely to prove preferable to
Option A for operational, programmatic and strategic reasons” in their Programmatic Update on
the Use of Antiretroviral Drugs for Treating Pregnant Women and Preventing HIV Infections in
Infants.
Under Option B+, all pregnant women diagnosed with HIV are offered lifelong ART
( a triple therapy TDF/3TC/EFV for pregnant women or TDF/3TC/NVP if the mother cannot
stand the toxicities of Efavirenz) plus cotrimoxazole prophlaxis at 14 weeks gestation,
irrespective of their CD4 count and infant prophylaxis is recommended for 6 weeks (NVP), then
do PCR at 6weeks encourage exclusive breastfeeding for 6months continue to breastfeed their
babies for one year and the baby is tested again if positive then the baby is started on ARVs
NVP can be given to mothers who cannot tolerate the toxicities of EFV.
Option B+ has additional benefits over both Options A and B