Regarding transmission of HIV to infant from infected HIV mother, which statement is/are true:a) Start zidovudine during labour.b) 25% chance of vertical transmissionc) Avoid breast feedingd) Vaccinate infant with OPV and MMRe) Cesarean section cause less transmission
High-Yield Explanation
According to the latest edition of Williams Obs 23/e, p 1252
An HIV infected woman on no antiretroviral medication who presents in labour Management includes: Start zidovudine i/v
OR
Start zidovudine plus a single dose of nevirapine. If nevirapine is initiated, consider adding lamivudine for 7 days post partum to decrease nevirapine resistance.
Williams Obs 23/e, p 1251, Table 59-8, p 1252
So option a is correct
Elective cesarean is the best mode of delivery as chances of transmission of HIV are less (i.e. option e is correct)
Breastfeeding should be avoided except in those cases where mother cannot afford formula feeds. (option c is correct).
Vertical transmission to the neonates is about 14-25%Q. (i.e. option b is correct) Transmission of HIV–2 is less frequent (1-4%) than for HIV-1 (15-40%)
Vaccination of HIV Infected Infant (Nelson)
Live oral polio vaccine (OPV) and BCG vaccine should not be given (i.e. option d is incorrect).
Varicella and MMR are recommended for children in immune categories. 1 and 2, but neither varicella nor MMR vaccines should be given to severely immunocompromised children (immune category 3).