prevmothertochildtransofhivppt32-经营管理(编辑修改稿)

prevmothertochildtransofhivppt32-经营管理(编辑修改稿)内容摘要：

• Arrange medical followup prior to discharge • Help mother access available social supports 来自 料库下载 Testing the Neonate • Maternal HIV antibodies may be found in the infant‟s serum for up to 18 months after delivery • Neonates are considered HIVinfected if two separate blood specimens test positive for HIV by DNA PCR, p24 antigen tests, or viral culture. 来自 料库下载 Barriers to Implementing MTCT Prevention Programs • Inadequacies in basic maternalchild health care infrastructure – Low, irregular and late presentation for prenatal care • Lack of prenatal counseling and testing programs • Cost of ART and monitoring • Attitudes of healthcare workers • Confidentiality issues • Discrimination • Dependence on breast feeding 来自 料库下载 Alternatives to HAART and the PACTG 076 AZT Regimen • Considerable research has been done to find a short, inexpensive and effective regimen of antiretrovirals to prevent MTCT • All of these regimens are inferior to HAART and the prolonged AZT regimen 来自 料库下载 AZT Trials Without Breastfeeding AZT regimen US Cost Efficacy (transmission rate) Thailand “short” Antepartum: 300 mg BID from 36 weeks Intrapartum: 300mg Q3H $200400 At 6 months: 9 % versus 19% in control group Thailand “4 group” Antepartum: 300 mg BID from either 28 or 36 wks Intrapartum: 300 mg Q3H Postpartum: 2mg/kg QID for 3 days or 6 wks variable At 6 months: 11% shortshort % short long % longshort % long long 来自 料库下载 AZT Trials With Breastfeeding AZT Regimen US Cost Efficacy (transmission rate) Ivory Coast and Burkina Faso DITRAME ANRS 049 Antepartum: 300mg BID at 3638 wks Intrapartum: 600mg Q3H Postpartum: 300mg BID X 1 wk $210360 18% vs. % at 6 months Combined analysis of these two studies: % vs. % at 15 months Ivory Coast Antepartum: 300mg BID at 36 wks Intrapartum: 300mg Q3H $200400 At 3 months % vs. % 来自 料库下载 PETRA trial (with breastfeeding) antepartum: 300 mg AZT BID + 3TC 150 mg BID start at 36 wks intrapartum: AZT 300 mg Q3H + 3TC 150 mg Q12H postartum: 300 mg AZT BID + 3TC 150 mg BID for 1 week US Cost Transmission in treatment group Transmission in con。