QuestionSBA
QuestionChoice
Peginterferon alfa and ribavirin are used in the management of chronic hepatitis C infection.
49995
d
Peginterferon alfa and ribavirin once weekly
QuestionChoice
Zidovudine monotherapy is used for post-exposure prophylaxis in an infant born to a low-risk mother (i.e. low viral load, <50 HIV RNA copies/mL). Zidovudine is also used for the management of untreated women presenting in labour at term, and is given intravenously throughout labour.
49993
b
Start daily zidovudine immediately
QuestionChoice
All pregnant women who have been diagnosed with HIV should start antiretroviral therapy (ART) during pregnancy and be advised to continue lifelong treatment. Tenofovir disoproxil/emtricitabine is a common first-line regime.
49992
a
Start daily tenofovir disoproxil/emtricitabine immediately
QuestionChoice
All pregnant women should be commenced on ART immediately. Tenofovir disoproxil monotherapy is sometimes used to treat pregnant women with hepatitis B infection.
49994
c
Plan to start tenofovir disoproxil daily in the third trimester
QuestionChoice
Benzathine penicillin is the recommended treatment option for syphilis infection
49996
e
Benzathine penicillin immediately, with a repeat dose in one week and in two weeks
QuestionComment
Starting ARTs, yes. The specific regimen? Highly specialised 
28582
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subscriber
Inpatient Syndrome
Concept
Chapter
# Overview

Patients with HIV should be supported in making an informed decision regarding the risks associated with their pregnancy and delivery.

Without intervention, the likelihood of passing HIV from mother to child is around 25-40%, 90% of which occurs during delivery. Infection is rarely passed in utero.

# Management

- It is imperative to start the mother on combination antiretroviral therapy (cART) as soon as a diagnosis is confirmed.
- If the mother's viral load is <50, a normal vaginal delivery can be recommended and supported. If the viral load is greater than 50, an elective caesarean section is recommended
- The baby will be recommended infant post exposure prophylaxis (PEP) with either zidovudine monotherapy or cART. The duration and choice of therapy depends on the risk of transmission (e.g. maternal viral load, resistance patterns)
- In the UK, the safest way to feed infants born to women with HIV is with formula milk, as there is no on-going risk of HIV exposure after birth
- However women with a low viral load on cART who choose to breastfeed should be informed of the risk of transmission, but supported to breastfeed if they wish, alongside additional monitoring.

# References

[Click here for the British HIV Association Guidelines on the management of HIv in pregnancy](https://www.bhiva.org/file/5f1aab1ab9aba/BHIVA-Pregnancy-guidelines-2020-3rd-interim-update.pdf)
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HIV and pregnancy
Topic
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Obstetrics
Video
Concept
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HIV and pregnancy
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HIV and pregnancy
Video
Concept
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HIV and pregnancy
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Quesmed Tutorial: Obstetrics 2
Condition
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Human immunodeficiency virus
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Infection
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Presentation
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Normal pregnancy and antenatal care
UkmlaTopic
18
Obstetrics and gynaecology
A 37-year-old nulliparous woman attends for her first antenatal appointment at approximately eight weeks gestation. She is routinely screened for HIV, syphilis and hepatitis B.

Her HIV test is reported as positive, and a confirmatory test is carried out.

What is the most appropriate management?
a