Option B+: Lifelong ART for ALL pregnant and breastfeeding women living with HIV, regardless of CD4 count or WHO stage.
1. Maternal Parameters
2. Infant Parameters
PMTCT Plan📚 Drug Pearls
PMTCT Evidence Summary
MTCT risk without intervention: 15 to 45% (5 to 10% in utero, 10 to 15% during labour, 5 to 20% through breastfeeding). With optimal PMTCT, risk reduces to < 2%.
Infant NVP Dosing by Weight
Birth Weight
NVP Dose
Volume (10mg/mL syrup)
≥ 2.5 kg
15mg OD
1.5 mL OD
2.0 to 2.49 kg
10mg OD
1.0 mL OD
< 2.0 kg
2mg/kg OD
Calculated per weight
Infant AZT Dosing (High-Risk Prophylaxis)
Birth Weight
AZT Dose
Volume (10mg/mL syrup)
≥ 2.5 kg
4mg/kg BD
Calculate per weight
2.0 to 2.49 kg
2mg/kg BD
Calculate per weight
< 2.0 kg
2mg/kg BD
Calculate per weight
Early Infant Diagnosis (EID) Schedule
Age
Test
Rationale
6 weeks
HIV DNA PCR (DBS)
First virological test. Detects in utero / intrapartum transmission.
6 months
HIV DNA PCR
Detects breastfeeding transmission. Repeat if still breastfeeding.
12 months
HIV DNA PCR (if breastfeeding)
End-of-breastfeeding test.
18 months
HIV Antibody (Rapid test)
Confirmatory. Maternal antibodies cleared by 18 months.
