Medical disorders in pregnancy: HIV and PMTCT: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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OBG · Medical disorders in pregnancy: HIV and PMTCT

Sample item

According to Indian NACO guidelines, what is offered to a pregnant woman newly diagnosed with HIV?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Lifelong antiretroviral therapy irrespective of CD4 count, starting as soon as possible

All pregnant women with HIV are started on lifelong ART (tenofovir, lamivudine and dolutegravir) regardless of CD4 count. This reduces mother-to-child transmission to below 2 per cent. The infant receives nevirapine prophylaxis, and breastfeeding is continued with maternal ART.

Option by option

  • A. ART only if CD4 is below 350

    CD4-based thresholds are outdated.

  • B. ART only during pregnancy and breastfeeding

    Stopping after breastfeeding is no longer practised.

  • C. Lifelong antiretroviral therapy irrespective of CD4 count, starting as soon as possible (correct)

    Correct. This is the universal treat-all approach.

  • D. No treatment, with caesarean delivery alone

    Caesarean alone does not suffice and is not routinely required if viral load is suppressed.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this OBG question

What is the answer to this OBG question?

The best answer is C, Lifelong antiretroviral therapy irrespective of CD4 count, starting as soon as possible. All pregnant women with HIV are started on lifelong ART (tenofovir, lamivudine and dolutegravir) regardless of CD4 count.

Why is "ART only if CD4 is below 350" not the answer?

CD4-based thresholds are outdated.

Why is "ART only during pregnancy and breastfeeding" not the answer?

Stopping after breastfeeding is no longer practised.

Why is "No treatment, with caesarean delivery alone" not the answer?

Caesarean alone does not suffice and is not routinely required if viral load is suppressed.

What concept does this question test?

It tests Medical disorders in pregnancy: HIV and PMTCT in OBG. This reduces mother-to-child transmission to below 2 per cent. The infant receives nevirapine prophylaxis, and breastfeeding is continued with maternal ART.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Medical disorders in pregnancy: HIV and PMTCT?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.