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MCQs in Tropical Medicine

Rob Skelly DTM+H FRCP

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Answer 63

Concerning HIV infection in pregnancy:
False a. pregnancy approximately doubles the rate of progression to AIDS
False b. the rate of vertical transmission of HIV is greater than 50%
True c. perinatal administration of zidovudine to the mother reduces vertical transmission
True d. breast feeding increases vertical transmission.

False e. transmission of HIV to the neonate is confirmed if the neonate is HIV antibody positive

The rate of progression of HIV to AIDS is probably not affected by pregnancy.
The rate of vertical transmission is about 15-35%. In Europe it is nearer 15% and in Africa nearer 30%.
Zidovudine appears to reduce vertical transmission by 2/3.
Nearly all babies born to HIV antibody positive mothers will get antibody to HIV via transplacental transfer. Only 15-35% of these will also be infected by the virus itself. It follows that detection of HIV antibody in neonates does not necessarily indicate HIV infection. HIV infection can be diagnosed by detection of HIV p24 antigen or detection of HIV antibody at age 18 months.
The rate of vertical transmission is increased by breast feeding and vaginal delivery. It is also increased if the mother has advanced disease.

Copyright: Rob Skelly 2006