
- hiv testing in pregnancy should be done early so as standard care can be taken for the pregnant women.


- this hiv testing must be repeated in the third trimester, usually before 36 weeks of gestation. This should be done in women with hiv-seronegative and also in pregnant women who are at a high risk of developing hiv infection.


- expedited hiv tests should be performed at the time of delivery and labor and this is a must in women who have not been documented for hiv. The results of the test should be available in one hour of the test and the testing should be available 24 hours. In case the results are positive then, infant postnatal antiretroviral and intrapartum drug prophylaxis should be started immediately.


- women who have not been able to be tested for hiv at the time of labor and delivery are suggested expedited screening for hiv. Their screening can be done immediately postpartum or their babies should undergo screening. In case the infant and mother, both are positive, then infant antiretroviral drug prophylaxis should be started immediately. These mothers should avoid breastfeeding their babies, until the supplemental hiv tests are negative. In infants with positive hiv, prophylaxis should be discontinued and antiretroviral drug therapy should be started.


- in case of acute hiv infection during pregnancy, that is in the intrapartum period, or during breast feeding, initial testing can be performed with an antigen/antibody combination immunoassay. If the supplemental test is negative, then an additional test which is the virologic test (dna, rna) are necessary for the diagnosis of the hiv infection.
- if the mother is hiv positive then this information must be documented in the infant's medical record and also communicated to the infants care provider.
The knowledge of an antenatal maternal hiv infection allows the:
- women with hiv infection to get the correct antiretroviral therapy along with prophylaxis for the infections which might occur due to the immunocompromised state of the body. This also prevents and decreases the risk of transmission to their partners.
- when there is provision for antiretroviral therapy for the mother during pregnancy and labor along with antiretroviral drug prophylaxis for the baby there is less risk of perinatal transmission of the hiv.
- the hiv infected women should be counseled for a cesarean delivery. The option of an elective cesarean reduces the perinatal transmission of the hiv.
- the hiv women should be counseled about the risk of breastfeeding.

Identification and Management of Perinatal HIV Treatment

HIV or the human immunodeficiency virus is a retroviral agent that causes the immune system of the body to weaken and lead to cause the acquired immune deficiency syndrome (AIDS). It is now treatable. Research is being conducted all over the world to formulate a targeted drug therapy for combating this life-threatening disease. No vaccine is available, which renders the world population highly susceptible to contract the infection.

HIV infection spreads from an infected person through contact with certain bodily fluids like blood and semen. Spread from one human being to another is called as transmission of HIV. Mother to child transmission, i.e. perinatal transmission is also common. Healthcare and hospital staff are at a great risk of occupational transmission. Other causes of transmission include sharing intravenous drug equipment, needle prick injury, organ transplantation and artificial insemination. Since vaccination and targeted drug therapy for remission are not available, prevention strategies play an important role in curbing the spread of infection.

A three-level prevention strategy is implemented for HIV infection.

Primary prevention- Activities that focus on prevention of uninfected people being infected.
Secondary prevention- Aimed at the provision of proper health care and behavioral facilities for HIV infected people like lifestyle changes, welfare rights advice, anti-discrimination measures.
Tertiary prevention- Aimed at minimizing the symptoms of an infected person; includes the provision of prophylactic drugs and complementary therapies.
The risk avoidance approach for transmission of HIV infection includes certain measures like practicing mutual monogamy & delayed sexual activity in the young population. Safe and appropriate use of syringes and needles is advised. Unnecessary blood transfusions should be completely avoided. Routine screening of HIV antibody should be done.

Risk reduction approach propagates the mandatory use of condoms during sexual intercourse. Sexually transmitted diseases should be treated to avoid the risk of transmitting infection. Sterile syringes should be used. If blood transfusion is necessary, then blood transfused should be evaluated well to meet the quality standards.

If HIV infection is suspected, anti-retroviral drug therapy should be started.
The only universally approved method of HIV transmission during sexual activity is the use of condoms.
Pharmaceutical methods for prevention and treatment include antibiotic drug therapy for sexually transmitted diseases, anti-retroviral drugs for infected individuals, pre and post-exposure prophylaxis and use of low space dead syringes.
Pre-exposure prophylaxis is advised for people who are at a higher than average risk of contracting the infection.
Drug therapy consisting of a combination of Tenofovir and Emtricitabine is prescribed, one per day.
Visit the physician at regular intervals and routine screening is done. Post-exposure prophylaxis is considered to be effective if the treatment is started within an hour of exposure, to effectively reduce the risk of seroconversion. A drug combination of Emtricitabine, Tenofovir and Raltegravir is given.
Social initiatives are undertaken to spread awareness and educate people regarding AIDS. Behavioral change and acceptance of social message is necessary to benefit from the social initiatives. Sex education, LGBT sex education and awareness, safe injection use programs, needle exchange programs, safe sex practice education are some social strategies implemented.
Prevention of transmission of HIV from mothers to children involves anti-retroviral drug therapy during pregnancy and post birth in the newborn child. Breastfeeding is avoided and bottle feeding is advised.

HIV Transmission - How Can It Be Prevented?

HIV infection and AIDS (commonly referred to as HIV/AIDS) are caused by the Human Immunodeficiency Virus (HIV). HIV is transmitted sexually and through exchange of body fluids, such as blood. The HIV attacks our defense system (immune system) giving opportunity to many illnesses to attack the body. These infections (called opportunistic infections) range from common cold and diarrhea to life-threatening illnesses including uncommon pneumonias and cancers. The type, range and intensity of opportunistic infections vary with the severity of the HIV infection and the extent to which our immunity is compromised. 

AIDS is the last stage disorder of the HIV infection. Though there is no complete cure for the HIV-infection till date - despite thousands of scientists across the world working on it, spending countless hours of research involving billions of dollars - there has been tremendous progress in medicare improving the quality of life of the HIV-infected, in extending their life-span to almost normal levels and in preventing mother-child transmission. 

The key factors in extending the life-span, and in keeping good immunity and good health are 

balanced and nutritious diet

regular physical exercise

correct, consistent and lifelong use of the prescribed medicines

periodic medical checkups

staying psychologically positive and strong

good family support and

good lifestyle habits.

The last one involves maintaining good personal hygiene, avoiding smoking (active as well as passive), alcohol, recreational drugs, unhygienic and disease-prone environments and sedentary life style. Those who follow these will guidelines certainly have better prognoses. 

Diet:

A nutritious diet is of utmost importance to the HIV-infected, as adequate nutrition contributes to the development of the immune system, prevents malnutrition and wasting, achieves and maintains optimal body weight and strength, enhances the body s ability to fight opportunistic infections, helps delay the progression of HIV, improves the effectiveness of drug treatments, and improves the quality of life. 

Ensure that the food contains adequate macronutrients, that is, carbohydrates, proteins and fat, otherwise the patient may end up with - protein-energy malnutrition, manifesting itself in the weight loss and wasting that is typical of AIDS patients.

As per WHO, an HIV-infected person has additional nutrient requirements: 10-15 percent additional energy intake and 50 to 100 percent increase in protein intake as compared to a non HIV-infected person.

Consuming micronutrients (especially Vitamins A, B6 and B12, iron and zinc) is important for building a strong immune system and fighting infections.

Try and maintain a daily diet containing rice/roti, vegetables, legumes, and fruits which provide you energy and micronutrients. Choose foods that are low in saturated fat, trans fat, and cholesterol.

Eat at least two servings of fish each week. Oily fish, which contain omega-3 fatty acids, are best. If you cannot eat fish, you can also get omega-3 fats from omega-3 eggs, walnuts, flax seeds.

Better avoid fast foods.

Living with HIV/AIDS: Diet, Nutrition, and Food Safety

If you indulge in unprotected sex, there are chances that you might get infected with HIV or the human immunodeficiency virus (a virus that gradually attacks the immune system). HIV is an infectious virus which can cause to AIDS or acquired immunodeficiency syndrome if left untreated. HIV may be transmitted via different ways, and becoming infected with HIV by having anal or vaginal sex without a condom is the commonest of all. Although there are several treatments for HIV, Ayurveda is considered to be the best form of natural treatment.

Ayurvedic treatment for HIV
Here are a few Ayurvedic remedies for treating HIV:

The first step is to provide a healthy atmosphere to the patient. The patient should be given easily digestible foods, which provide nourishment to the body. Regular and easy exercises should be undertaken by the patient, who should also participate in productive activities.
Several Ayurvedic tonics and rejuvenators or rasayanas are given to the patient in order to boost his immunity level. The overall system gets strengthened, and the appetite gets stimulated.
When the patient gains some strength, shodhana techniques are used for eliminating toxins from the body via purgation, emesis and enemas. Certain ghee-based medicines are also given to the patient. Proper medication purifies the blood. Measures for correction of liver issues should also be taken.
Your diet should consist of preparations made of ghee and soups. You should avoid oily, spicy and acidic food items. A little amount of alcohol may be taken as that aids the digestive process.
Regular exercise causes the blood to heat, which may weaken or eliminate the virus in some cases.
There are some herbo-mineral compounds, which are prepared using an Ayurverdic formula. These compounds have rasayana and vajikara effects and are considered to be effective for HIV patients.
There are several proprietary Ayurvedic medicines, which help in improving the condition of patients infectedwith HIV. These may include Chyawanprash, Raktavardhak and Sookshma Triphala. These keep the HIV infectionat bay. Shatavari Kalpa,Guduchi and Kalmegh are other effective Ayurvedic medicines.
Chyawanprash is an effective Ayurvedic remedy which is used for the treatment of HIV. It is considered the best Ayurvedic tonic for rejuvenation from HIV. The Indian gooseberry or aamlaki is the main ingredient of Chyawanprash, which is rich in vitamin C. It also contains naturally-occurring antioxidants. Gooseberries are antifungal, antibacterial and antiviral in nature. Chyawanprash comprises of 35 Ayurvedic herbs, which enhances the effect of the main ingredient in treating HIV.
Ayurvedic remedies and methods for the treatment of HIV are harmless and totally safe. There are no side effects, and Ayurvedic remedies only improve the symptoms of HIV, and no deterioration is caused in the condition of the patient.

Ayurveda - Can It Help Treat HIV?

Acquired Immune Deficiency Syndrome(AIDS) is caused by a virus called Human Immunodeficiency virus (HIV). It should be remembered that it is not necessary that a person having HIV is suffering from AIDS or will inevitably result in it. The illness damages the immune system of the person and makes them more vulnerable to diseases and infections. As the syndrome progresses, opportunistic infections attack the patient, ultimately causing their death.

What are the causes of AIDS?
The virus is spread by person-to-person contact like:
1. Through sexual contact.
2. By sharing the same needle or through blood transfusion.
3. The disease can be spread from mother to the newborn child.

What are the symptoms of AIDS?
1. You may have a high fever or suffer from constant diarrhea which may last for weeks.
2. Red rashes may appear on your skin.
3. You may feel weak and tired all the time.
4. You may have excessive sweating, particularly at night.
5. Your muscles and joints may ache.
6. Your swollen glands don t heal for weeks.

What are the complications related to AIDS?
During the last stage of infection, there is a high risk of having life-threatening diseases.These include:
1. Infections to the nervous system like meningitis, peripheral neuropathy.
2. Inflammation in the lower end of the esophagus.
3. Cancers like cervical cancer, neck cancer, and lymphomas.
4. Tuberculosis.

Can AIDS be treated with homeopathy?
Homeopathic treatment can be of a great help for such patients. It can boost up not only physical health but mental health too. It can combat opportunistic infections very effectively by boosting up the immunity of the patient. There are marvellous results with homeopathic medicines tried in Africa (an epidemic zone for AIDS). Many patients of AIDS are still waiting to die after using homeopathy and their quality of life has improved drastically. Homeopathy works by modulating the immunity which is an important factor in AIDS patient. Some of the homeopathy medicine used to treat symptoms of AIDS are:
1. Syphilinum
2. Arsenic iodum
3. Sulphur
4. Silica,
5. Tuberculinum
6. Kali carbonicum
7. Calcaria iodum
8. Bacillinum
9. Arsenica Album
10. Phosphorus
These medications can be used in conjuction with ART or antiretroviral therapy along with other treatments and has been shown to be very effective in alleviating some of the commonly encountered symptoms of AIDS related complications. But utmost care must ensured and these medicines should not be taken without consulting a homeopathic doctor.

HIV / AIDS - Can Homeopathy Medicines Helps in Treating it

Spread of HIV infection from a woman who has transmits HIV to her child during pregnancy, childbirth (labor and delivery), or breastfeeding (breast milk) is called as  Mother to child  transmission (MTCT) of HIV. It is also termed as the perinatal transmission of the HIV infection or  vertical  transmission. In the absence of medical intervention, perinatal transmission rates are very high, between 20-45% in different parts of the world. In various regions of the African subcontinent a large number of HIV infected children are present. It is a major cause of deaths in teens and adolescents in that region. 

Almost 90% of all HIV infected children live in the sub-Saharan Africa. In some districts of AP, Karnataka, Maharashtra and TN that were highly HIV-prone, we have several HIV infected children and adolescents. The virus replicates in the body and affects the immune system. Due to decreased immunity, various opportunistic infections enter the body and cause AIDS related symptoms. Prevention of HIV infection in infants and young children is now a high priority and has been the rallying point for enhanced prevention efforts. MTCT HIV infection can be prevented with adequate measures by way of Anti-retroviral treatment (ART). All expecting mothers who are HIV infected should have access to the preventive medical services throughout the gestation period, during labor and also during breastfeeding. 



Proper provision of resources with skilled staff and awareness programs can help in avoiding new infection cases. Breastfeeding is the primary source of transmission of infection from mother to child. Basically, once ART is started in an HIV infected pregnant woman that should continue forever. With proper ART course, chances of MTCT are near Zero. At the Unison Medicare & Research Centre; which is India s first fully comprehensive clinic for HIV Care and infectious Diseases, during last decade, not a single MTCT has occurred after treating more than 160 such HIV infected mothers. Even prior to that MTCT rate was lower than 1%. Our motto has been making the mothers virally suppressed commensurate with the global principle of  Undetectable = Untransmittable ! In fact now more and more HIV infected couples have been coming forward for an elective pregnancy. Even HIV un-infected children orphaned by AIDS or living with sick caregivers are at the great risk of emotional and physical abuse, which in turn increases the child s vulnerability to HIV infection. 

Reduction of risks to these vulnerable children is of great importance and various programs are being implemented for the welfare of orphans and vulnerable children. Various risk factors that are implicated in the transmission of HIV infection from mother to child are as follows: 

Increased viral load 
Genital tract viral load 
Reduced CD4 cell count 
Unprotected sexual intercourse with infected partner 
Smoking, Substance and drug abuse 
Deficiency of Vitamin A and other essential nutrients 
Presence of other Sexually transmitted diseases (STDs) 
Pre-term delivery 
Placental disruption 
Invasive monitoring of the fetus 
Breast feeding In most cases, HIV will not cross through the placenta from mother to baby. 
In an otherwise healthy mother, risk of child getting infected is low. Prenatal visits shouldn t be increased until a complication arises. The physician should observe symptoms of AIDS and pregnancy-related complications on a regular basis. HIV may be the direct cause or a marker of a complex interaction of related medical and social conditions that affect pregnancy. Most HIV positive women are usually asymptomatic and have no major obstetrical problems during their gestation period. They should receive similar obstetric antenatal care as the HIV-negative women, unless indicated by the need to provide specific treatment for HIV related conditions. There is no evidence of a need to increase the number of antenatal visits, provided there are no complications of the HIV infection, although additional counseling sessions may be required to reassure the mother and family. 

Care of the HIV positive woman during pregnancy should include ongoing counseling and support as an integral part of the management. Invasive diagnostic procedures, such as chorionic villus sampling, amniocentesis or cordo-centesis should be avoided wherever possible, due to a possible risk of infection of the fetus. In case you have a concern or query you can always consult an expert & get answers to your questions!

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