Intrapartum antiretroviral therapy
Australasian Society for Infections Diseases (ASID), 2022
Intrapartum antiretroviral therapy to prevent perinatal transmission of HIV is not required if the pregnant person is taking antiretroviral therapy and has an undetectable viral load near birth.
If the pregnant person’s HIV viral load near birth is more than 1000 HIV RNA copies/mL or is unknown, intrapartum zidovudine is indicated. In addition to the pregnant person’s usual antiretroviral regimen, use:
zidovudine 2 mg/kg intravenously over 1 hour, 3 hours before anticipated caesarean section or at the onset of labour, followed by 1 mg/kg/hour intravenously until the umbilical cord is clamped12. For dosage adjustment in adults with kidney impairment, see zidovudine dosage adjustment.zidovudinezidovudinezidovudine
If the pregnant person’s HIV viral load near birth is detectable but less than 1000 copies/mL, intrapartum zidovudine may be considered on a case-by-case basis. The decision to use intrapartum zidovudine, depends on the plan for neonatal antiretroviral prophylaxis – seek expert advice.