Thai national guidelines for the prevention of mother-to-child transmission of human immunodeficiency virus 2017

Details

• Alternative Title:
  Asian Biomed (Res Rev News)
• Personal Author:
  Lolekha, Rangsima ; Chokephaibulkit, Kulkanya ; Phanuphak, Nittaya ; Chaithongwongwatthana, Surasith ; Kiertiburanakul, Sasisopin ; Chetchotisakd, Pleonchan ; Boonsuk, Sarawut
• Corporate Authors:
  for the Thai national prevention of mother-to-child transmission (PMTCT) Guidelines Working Group
• Description:
  Background
  
  Thailand has made progress in reducing perinatal HIV transmission rates to levels that meet the World Health Organization targets for so-called “elimination” (<2%) of mother-to-child transmission (MTCT).
  
  Objectives
  
  To highlight the Thailand National Guidelines on HIV/AIDS Treatment Prevention Working Group issued a new version of its National Prevention of MTCT guidelines in March 2017 aimed to reduce MTCT rate to <1% by 2020.
  
  Discussion of guidelines
  
  The guidelines include recommending initiation of antepartum antiretroviral therapy (ART) containing tenofovir disoproxil fumarate (TDF) plus lamivudine (3TC)/emtricitabine (FTC) plus efavirenz regardless of CD4 cell count as soon as HIV is diagnosed for ART naïve HIV-infected pregnant women. An alternative regimen is TDF or zidovudine (AZT) plus 3TC/FTC plus lopinavir/ritonavir (LPV/r) for HIV-infected pregnant women suspected resistant to non-nucleoside reverse transcriptase inhibitors. Treatment should be started immediately irrespective of gestational age and continued after delivery for life. Raltegravir is recommended in addition to the ART regimen for HIV-infected pregnant women who present late (gestational age (GA) ≥32 weeks) or those who have a viral load (VL) >1000 copies/mL at GA ≥32 weeks. HIV-infected pregnant women who conceive while receiving ART should continue their treatment regimen during pregnancy. HIV-infected pregnant women who present in labor and are not receiving ART should receive single-dose nevirapine immediately along with oral AZT, and continue ART for life. Infants born to HIV-infected mothers are categorized as high or standard risk for MTCT. High MTCT risk is defined as an infant whose mother has a viral load (VL) > 50 copies/mL at GA > 36 weeks or has received ART <12 weeks before delivery, or has poor ART adherence. These infants should be started on AZT plus 3TC plus NVP for 6 weeks after delivery. Infants with standard MTCT risk should receive AZT for 4 weeks. Formula feeding exclusively is recommended for all HIV-exposed infants.
  
  
• Keywords:
  Guidelines HIV Mother-to-child Transmission Thailand
• Source:
  Asian Biomed (Res Rev News). 11(2):145-159
• Pubmed ID:
  29861798
• Pubmed Central ID:
  PMC5978732
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHSUnited States/
• Volume:
  11
• Issue:
  2
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:620204026965442b68414f14d31d37bdab9c27575284def1e8333a3a63add445
• Download URL:
  https://stacks.cdc.gov/view/cdc/55665/cdc_55665_DS1.pdf
• File Type:
  [PDF - 550.07 KB ]