<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_1905-7415.1102.547_s_020_w2aab3b7c23b1b6b1aab1c15b1Aa"><h3>Background</h3><p>Thailand has made progress in reducing perinatal HIV transmission rates to levels that meet the World Health Organization targets for so-called “elimination” (&lt;2%) of mother-to-child transmission (MTCT).</p></sec><sec id="j_1905-7415.1102.547_s_021_w2aab3b7c23b1b6b1aab1c15b2Aa"><h3>Objectives</h3><p>To highlight the Thailand National Guidelines on HIV/AIDS Treatment Prevention Working Group issued a new version of its National Prevention of MTCT guidelines in March 2017 aimed to reduce MTCT rate to &lt;1% by 2020.</p></sec><sec id="j_1905-7415.1102.547_s_022_w2aab3b7c23b1b6b1aab1c15b3Aa"><h3>Discussion of guidelines</h3><p>The guidelines include recommending initiation of antepartum antiretroviral therapy (ART) containing tenofovir disoproxil fumarate (TDF) plus lamivudine (3TC)/emtricitabine (FTC) plus efavirenz regardless of CD4 cell count as soon as HIV is diagnosed for ART naïve HIV-infected pregnant women. An alternative regimen is TDF or zidovudine (AZT) plus 3TC/FTC plus lopinavir/ritonavir (LPV/r) for HIV-infected pregnant women suspected resistant to non-nucleoside reverse transcriptase inhibitors. Treatment should be started immediately irrespective of gestational age and continued after delivery for life. Raltegravir is recommended in addition to the ART regimen for HIV-infected pregnant women who present late (gestational age (GA) ≥32 weeks) or those who have a viral load (VL) >1000 copies/mL at GA ≥32 weeks. HIV-infected pregnant women who conceive while receiving ART should continue their treatment regimen during pregnancy. HIV-infected pregnant women who present in labor and are not receiving ART should receive single-dose nevirapine immediately along with oral AZT, and continue ART for life. Infants born to HIV-infected mothers are categorized as high or standard risk for MTCT. High MTCT risk is defined as an infant whose mother has a viral load (VL) > 50 copies/mL at GA > 36 weeks or has received ART &lt;12 weeks before delivery, or has poor ART adherence. These infants should be started on AZT plus 3TC plus NVP for 6 weeks after delivery. Infants with standard MTCT risk should receive AZT for 4 weeks. Formula feeding exclusively is recommended for all HIV-exposed infants.</p></sec></abstract>

BackgroundThailand has made progress in reducing perinatal HIV transmission rates to levels that meet the World Health Organization targets for so-called “elimination” (<2%) of mother-to-child transmission (MTCT).ObjectivesTo highlight the Thailand National Guidelines on HIV/AIDS Treatment Prevention Working Group issued a new version of its National Prevention of MTCT guidelines in March 2017 aimed to reduce MTCT rate to <1% by 2020.Discussion of guidelinesThe guidelines include recommending initiation of antepartum antiretroviral therapy (ART) containing tenofovir disoproxil fumarate (TDF) plus lamivudine (3TC)/emtricitabine (FTC) plus efavirenz regardless of CD4 cell count as soon as HIV is diagnosed for ART naïve HIV-infected pregnant women. An alternative regimen is TDF or zidovudine (AZT) plus 3TC/FTC plus lopinavir/ritonavir (LPV/r) for HIV-infected pregnant women suspected resistant to non-nucleoside reverse transcriptase inhibitors. Treatment should be started immediately irrespective of gestational age and continued after delivery for life. Raltegravir is recommended in addition to the ART regimen for HIV-infected pregnant women who present late (gestational age (GA) ≥32 weeks) or those who have a viral load (VL) >1000 copies/mL at GA ≥32 weeks. HIV-infected pregnant women who conceive while receiving ART should continue their treatment regimen during pregnancy. HIV-infected pregnant women who present in labor and are not receiving ART should receive single-dose nevirapine immediately along with oral AZT, and continue ART for life. Infants born to HIV-infected mothers are categorized as high or standard risk for MTCT. High MTCT risk is defined as an infant whose mother has a viral load (VL) > 50 copies/mL at GA > 36 weeks or has received ART <12 weeks before delivery, or has poor ART adherence. These infants should be started on AZT plus 3TC plus NVP for 6 weeks after delivery. Infants with standard MTCT risk should receive AZT for 4 weeks. Formula feeding exclusively is recommended for all HIV-exposed infants.

Thai national guidelines for the prevention of mother-to-child transmission of human immunodeficiency virus 2017

Department of Pediatrics, Faculty of Medicine, Siriraj Hospital

Department of Obstetrics and Gynecology, Faculty of Medicine

Department of Medicine, Faculty of Medicine Ramathibodi Hospital

Department of Medicine, Faculty of Medicine

Asian Biomedicine

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

BackgroundThailand has made progress in reducing perinatal HIV transmission rates to levels that meet the World Health Organization targets for so-called “elimination” (1000 copies/mL at GA ≥32 weeks. HIV-infected pregnant women who conceive while receiving ART should continue their treatment regimen during pregnancy. HIV-infected pregnant women who present in labor and are not receiving ART should receive single-dose nevirapine immediately along with oral AZT, and continue ART for life. Infants born to HIV-infected mothers are categorized as high or standard risk for MTCT. High MTCT risk is defined as an infant whose mother has a viral load (VL) > 50 copies/mL at GA > 36 weeks or has received ART <12 weeks before delivery, or has poor ART adherence. These infants should be started on AZT plus 3TC plus NVP for 6 weeks after delivery. Infants with standard MTCT risk should receive AZT for 4 weeks. Formula feeding exclusively is recommended for all HIV-exposed infants.

BackgroundThailand has made progress in reducing perinatal HIV transmission rates to levels that meet the World Health Organization targets for so-called...

Thai national guidelines for the prevention of mother-to-child transmission of human immunodeficiency virus 2017

Article Category: Original Article

Published Online: Aug 31, 2017

Page range: 127 - 144

DOI: https://doi.org/10.5372/1905-7415.1102.547

Keywords
Guidelines, HIV, mother-to-child transmission, Thailand

© 2017 Rangsima Lolekha, Kulkanya Chokephaibulkit, Nittaya Phanuphak, Surasith Chaithongwongwatthana, Sasisopin Kiertiburanakul, Pleonchan Chetchotisakd, Sarawut Boonsuk

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Thai national guidelines for the prevention of mother-to-child transmission of human immunodeficiency virus 2017

Article Category: Original Article

Published Online: Aug 31, 2017

Page range: 127 - 144

DOI: https://doi.org/10.5372/1905-7415.1102.547

KeywordsGuidelines, HIV, mother-to-child transmission, Thailand

© 2017 Rangsima Lolekha, Kulkanya Chokephaibulkit, Nittaya Phanuphak, Surasith Chaithongwongwatthana, Sasisopin Kiertiburanakul, Pleonchan Chetchotisakd, Sarawut Boonsuk

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Keywords
Guidelines, HIV, mother-to-child transmission, Thailand