Table 1.
WHO Programme Options for ART for PMTCT, 2013
| National PMTCT programme option | Pregnant and breastfeeding women with HIV | HIV-exposed infant | ||
|---|---|---|---|---|
| Use lifelong ART for all pregnant and breastfeeding women (“Option B+”) | Regardless of WHO clinical stage or CD4 cell count | Breastfeeding | Replacement feeding | |
| Initiate ART and maintain after delivery and cessation of breastfeeding | 6 weeks of infant prophylaxis with once-daily NVP | 4-6 weeks of infant prophylaxis with once-daily NVP (or twice-daily AZT) | ||
| Use lifelong ART only for pregnant and breastfeeding women eligible for treatment (“Option B”) | Eligible for treatment a | Not eligible for treatment a | ||
| Initiate ART and maintain after delivery and cessation of breastfeeding b | Initiate ART and stop after delivery and cessation of breastfeeding b c | |||
CD4 count ≤500 cells/mm3 or clinical stage 3 or 4 disease at the time of ART initiation or in accordance with national guidelines.
Patients who develop clinical or laboratory criteria indicating failure during pregnancy or the breastfeeding period should be assessed for second-line therapy.
In the case of breastfeeding, stop ART one week after breastfeeding ends. In the case of replacement feeding, stop ART after delivery.
Reproduced, with the permission of the publisher, from the Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection. Recommendations for a public health approach June 2013. Geneva, World Health Organization, 2013 (Table 7.3, Page 101 http://apps.who.int/iris/bitstream/10665/85321/1/9789241505727_eng.pdf, accessed 07 March 2014)”
Abbreviations: PMTCT: Prevention of Mother-to-Child Transmission of HIV; ART: Antiretroviral Therapy; WHO: World Health Organization; NVP: Nevirapine; AZT: Zidovudine