
- 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

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!

How Can We Achieve HIV-Free Generation?

Hiv or the human immunodeficiency virus is the lentivirus which causes hiv infection and leads to acquired immunodeficiency syndrome or aids.

The symptoms of hiv vary from person to person. There are three main stages of hiv infections, where each stage has different symptoms.

Here are some facts about the three stages of hiv infections along with the accompanying symptoms.

Acute hiv infection stage
This is the first stage of hiv infection and after three to four weeks of becoming hiv infected, people experience symptoms, which are similar to flu. This flu usually does not last more than two weeks.

Symptoms include:
Fever
Rashes on the body
A sore throat
Swelling of different glands
Headache
Joint and muscle pain
Improper digestion

These symptoms appear and indicate that the body is reacting to the hiv. Infected cells circulate throughout the blood, and the immune system produces hiv antibodies in order to attack the viruses. This process is termed as seroconversion, and it takes place within 45 days of getting infected. The levels of virus in your blood are quite high during this stage.

Clinical latency stage
This is the second stage of hiv infection, which follows the early stage. This stage is also known as chronic hiv stage. During this stage, hiv is active, but is reproduced at a very low level. People in this stage may not receive symptoms related to hiv or may get mild indications.

In case of people who do not take medicines for hiv treatment, this stage lasts for a long period. Some people, however, progress faster through this stage. Medicines should be taken to keep the virus in check. During this stage, people can transmit hiv to others very easily in spite of not experiencing any symptoms. People who are on medication stay suppressed virally and have a low level of hiv in their blood, and the risk of transmission is less.

Symptomic hiv infection or aids stage
This is the third stage of hiv infection, which is characterized by severe damage to the immune system of an hiv-virus affected person. A patient is likely to have serious infections and gets bacterial or fungal diseases. The infections are termed as opportunistic infections. The patient is now said to be having aids.

The symptoms of this stage are:
Loss of weight
Diarrhoea
Sweating at night
Fevers and persistent coughing
Problems in the mouth and skin
Infections on a regular basis
Illness and development of other diseases.

Hiv infection affects the body via three stages and leads to aids in the third stage. Each stage is accompanied by several symptoms.

Stages and Symptoms of HIV Infections

HIV or Human Immunodeficiency Virus is a type of immune disorder which attacks the immune system of the body and slowly destroys it overtime. The HIV virus targets the immune system and makes the body susceptible to other diseases. HIV infection can progress to AIDS although it may take up to 10 or 12 years to fully go into the last stage.

Risks and Causes
HIV is a communicable disease which spreads through only the following methods

    It can spread from one person to another by means of unprotected sexual intercourse due to the exchange of bodily fluids.
    The virus spreads if you share drug needles with someone who is already contaminated with HIV virus. It can also occur due to improperly trained medical staff that may reuse syringes although this is very uncommon.
    The HIV virus transmits from the mother to the child during pregnancy through the placenta.
    Any exchange of blood in significant amounts such as blood transfusion from a contaminated patient will result in infection as well although this is very rare.

Any other form of contracting the disease such as through kissing or food is a untrue and only propagates due to ignorance.

Symptoms
The initial symptoms of HIV infection are noticed after a few weeks although it can take a few months to come up as well. The initial symptoms may include
1. Severe headache along with intense pain in the muscles and the joints of the body.
2. Frequent appearances of rashes
3. inflation of the lymph nodes
4. Itchy skin
5. Disorders which stay for sustained periods such as an upset stomach or a cold.

The early symptoms disappear within 2 to 3 weeks without any treatment. The later symptoms might appear after few years (sometimes up to or more than a decade), which will stay. This is usually the time HIV is diagnosed. The symptoms now may also include
1. severe muscle fatigue
2. severe loss in body weight,
3. High fever and recurrent instances of sweating at the night time.
HIV is suspected if the later symptoms tend to last for a long time without any other diagnosable cause.

Treatment
HIV can be treated by means of antiretroviral therapy which reduces the rate at which the virus multiplies. However, there is no cure for HIV as of yet.
Prevention
In order to prevent yourself from getting HIV, you should adopt the following precautionary measures:
1. You should use protection every time when engaging in sexual intercourse and if you are unsure of your partner s HIV status.
2. You should use new blades in barbershops for shaving purposes in order to prevent yourself from HIV as well
3. If you are diagnosed with HIV/AIDS while you are pregnant, to prevent spreading it to your unborn baby, you might immediately need undergo a medical check-up and follow the doctor s advice.
4. Ensure that disposable syringes are used whenever they are being use for medical tests or treatments.

HIV / AIDS - Things You Should Remember About It

Sadly, there is no known cure for hiv. However, it can be controlled through medication. Hiv or the human immunodeficiency virus attacks the body's immune system and over time leaves it vulnerable to a number of other diseases. In its most advanced stages, it can lead to aids. Hence, it is essential to control this virus in its early stages.

Hiv treatment is known as antiretroviral therapy or art. This involves taking a series of hiv medicines on a daily basis. Art can help hiv patients live a longer, healthier life and can also reduce the risk of hiv transmission.

The first step towards getting treated for hiv is to get tested. This can be easily done at your nearest health center and the results will be kept confidential. With hiv prevention is better than cure and hence, if you have more than one sexual partner, you must insist on them getting tested as well.

As soon as you test positive for the virus, start the treatment. Do not wait till you start feeling sick. Art can be taken by anyone at any stage of the condition. If you are pregnant, breast feeding or have been diagnosed with early hiv infection, this is all the more important.

Hiv medication works by preventing the hiv cells from multiplying and thus reduces the amount of hiv cells in the body. A low level of hiv cells gives the immune system a chance to recover and strengthen itself. A lowered hiv count also reduces chances of transferring the virus to another person.

Art involves following a regimen of a number of medicines. There are 25 hiv medicines that can be grouped under six drug classes depending on how they affect hiv cells. These include:

1. Nucleoside reverse transcriptase inhibitors
2. Non-nucleoside reverse transcriptase inhibitors
3. Protease inhibitors
4. Fusion and entry inhibitors
5. Pharmacokinetic enhancers and
6. Integrase strand transfer inhibitors

Usually, a person is prescribed 3-4 hiv medicines from a minimum of 2 drug classes. A number of factors go into deciding what form of hiv treatment is most suitable to a patient. This includes the person's individual needs, symptoms presented, potential drug interactions and possible side effects. Convenience of following the regimen and costs are also taken into account while prescribing a form of treatment to a hiv patient.

Once treatment is started, art can be proven to be effective within 3-6 months by lowering the number of hiv cells in the body.

HIV/AIDS - How Can It Be Treated?

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?

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