Question

Patience is 29 years old and has been HIV positive for 9 years. She has remained asymptomatic and is not taking antiretroviral medication. Recently she was at the drop-in clinic to talk to a public health nurse about having a baby through artificial insemination. She said she had met a man who wanted to marry her and have children with her, but she was concerned about the baby contracting her HIV infection. Her latest blood tests indicated her CD4⁺ count was 380/µL. The nurse referred her to the physician to discuss antiretroviral therapy during her pregnancy.

1. Outline the factors that increase the chance of HIV transmission from mother to infant and how transmission occurs.
   
2. Patience was told that after she became pregnant she would begin HAART therapy. Describe what this therapy is and what particular antiretroviral medication would be particularly useful to her during her pregnancy. What concern is there about administering certain antiretrovirals early in the pregnancy?
   
3. Individuals infected with HIV are prone to contracting opportunistic infections. Define opportunistic infection and outline the risk factors that leave an individual with HIV infection prone to contracting this type of illness.
   

Answer 1

1.Factors

During pregnancy, illegal drug use

Sexual intercourse frequency during pregnancy

Amount of Pregnancy Sex Partners

Practices for baby feeding: breastfeeding, mixed feeding, premastication of food

2.HAART

Highly active antiretroviral therapy.

As soon as possible irrespective of gestational age, HIV-infected pregnant women in need of ART for their own health should commence ART and continue during pregnancy , childbirth, breastfeeding (if breastfeeding), and afterwards.

The recommended first-line ART regimen for pregnant women who need ART for their own wellbeing should include an AZT + 3TC backbone paired with an NNRTI: AZT + 3TC + NVP or AZT + 3TC + EFV. TDF + 3TC (or FTC) + EFV and TDF + 3TC (or FTC) + NVP are the recommended alternative regimens. (Note: in the first trimester, avoid the use of EFV and use NVP instead.)

Therefore, ARV regimens initiated during pregnancy should, if possible, contain a high transplacental passage nucleoside reverse transcriptase inhibitor (NRTI) such as lamivudine (3TC), emtricitabine (FTC), tenofovir disoproxil fumarate (TDF), or abacavir (ABC)

3.Pneumonia, Salmonella infection, candidiasis, toxoplasmosis, and Tuberculosis ( TB) are HIV-related OIs. For people with HIV, taking HIV medication every day is the best defence against OIs. HIV drugs protect the immune system from being weakened by HIV.

The most prevalent threats are:

Getting Sex Unprotected. By having sex, most individuals get HIV. ..

Usage of Medicines. Using needles to administer medicine makes the HIV risks higher. ..

Getting some problems with wellbeing. It makes the risk of HIV higher to have a sexually transmitted infection ( STI). ..

Products of Blood. ..

.. ...