PMTCT ART FLOWCHART

Start ART immediately: FDC ** After 1 week, if Creatinine

> 85moll/l swithc to AZT **see clinical guidelines for maternal
regimens
Ask about risk: Unprotected sex /
intravenous drug users/ STIs
Retest mother at 6 week post natal visit and then
every 3 months until end of breastfeeding
Begin Adherence counselling / nutrition counselling /
CD4 test / stage patient
Advise women to come to clinic when they
STOP BREASTFEEDING to do CD4 test
Phone patient to arrange clinic visit to discuss
CD4 result within 1 week
HIV POSITIVE mother:
Do CD4 and
Creatinine tests
See Adult Algorithm
IF CD4 350 or
stage III / IV
continue lifelong ART
IF CD4 >350 and
breastfeeding has stopped,
enroll mother
in wellness program
HIV
NEGATIVE
mother
IF POSITIVE
POST NATAL
IF POSITIVE
Re-test every 3 months until delivery
At 6 weeks do HIV PCR test at the 6 week EPI visit
Post Natal Care
for Infants
HIV+ Mother on ART:
Infant gets NVP at
birth and then
daily for 6 weeks
See clinical guidelines
for infant dosing
protocol
Immediately
begin
on ART
Unknown maternal status /
abandoned / orphaned:
Start NVP immediately then do
HIV antibody test. If positive
continue NVP, if negative stop NVP
Do HIV rapid test
6 weeks after last day
of breast feeding
or at >18 months
HIV+ Mother who did
not get ARVs before or
during delivery:
NVP ASAP and daily
for 6 weeks
POSITIVE NEGATIVE
IF POSITIVE