The document discusses strategies for preventing mother-to-child transmission of HIV (PMTCT), including drug regimens for pregnant women and newborns. It provides details on regimens involving zidovudine alone or combined with other antiretrovirals. These regimens can reduce transmission rates to below 2% when combined with planned cesarean delivery before labor and avoidance of breastfeeding. Core WHO recommendations include voluntary testing and treatment for pregnant women as well as protecting patient confidentiality and rights.

1. 06/07/09 Dr.Sujnanendra Mishra Dr.Sujnanendra Mishra. M.D.(O&G) Sub Divisional Hospital. PATNAGARH. BOLANGIR. PMTCT - - - CAN IT BE A THING OF PAST ?

2. 06/07/09 Dr.Sujnanendra Mishra Welcome you to this brain storming session on HIV. CHIEF DISTRICT MEDICAL OFFICER & ASSOCIATES BOLANGIR

3. 06/07/09 Dr.Sujnanendra Mishra HIV in INDIA

4. 06/07/09 Dr.Sujnanendra Mishra

5. 06/07/09 Dr.Sujnanendra Mishra Expanding Disease Burden 1986 to 2005

6. Mothers are always Targeted : 06/07/09 Dr.Sujnanendra Mishra “ Men Think females Bring The Disease”

7. 06/07/09 Dr.Sujnanendra Mishra Prevention of Parent- to- Child Transmission (“PPTCT”) ( generally known as “ PMTCT”) To be REPLACED BY

8. 06/07/09 Dr.Sujnanendra Mishra Rationale for PPTCT in India 27 million pregnancies per year 1,89,000 infected pregnancies per year Cohort of 56,700-60,000 infected newborns per year 0.7% prevalence 30% transmission

9. HIV antibody Quantitative viral load Qualitative HIV DNA Absolute CD4+ cell count High risk of progression Moderate risk of progression Low risk of progression Weeks of Infection 0 1 2 3 4 5 6 7 8 9 10 11 12 14 26 SCHEMATIC OF LABORATORY FINDINGS IN PRIMARY HIV INFECTION ACUTE RETROVIRAL SYNDROME

10. Transmission during Pregnancy Perinatal & Breastfeeding 06/07/09 Dr.Sujnanendra Mishra 0% 20% 40% 60% 80% 100% Early Antenatal (<36 wks) Late Antenatal (36 wks to labor) Labor and Delivery Late Postpartum (6-24 months) Early Postpartum (0-6 months) Proportion of infections

29. 06/07/09 Dr.Sujnanendra Mishra Four classes of ARV drugs approved

30. HIV REPLICATION 06/07/09 Dr.Sujnanendra Mishra

62. 06/07/09 Dr.Sujnanendra Mishra Thanks for Saving me Let The FUTURE say ;

63. 06/07/09 Dr.Sujnanendra Mishra PPTCT HELPS PROTECT THE FUTURE

64. 06/07/09 Dr.Sujnanendra Mishra THANK YOU