AIIMS CRE 2025
Pharmacology
Easy
Which ARV drug is included to prevent mother-to-child transmission during breastfeeding?
Appeared in: AIIMS CRE 2025
Explanation
- Nevirapine is the antiretroviral drug recommended by the World Health Organization (WHO) for extended daily prophylaxis in infants who are breastfeeding from an HIV-positive mother.
- This strategy is designed to provide a protective barrier against the HIV virus that can be transmitted through breast milk.
- While initial prophylaxis might use other agents, Nevirapine is the standard for the entire duration of breastfeeding to minimize postnatal transmission risk.
Why Other Options Were Wrong
- Option A: Zidovudine is primarily used for the initial 4-6 weeks of neonatal prophylaxis, not for the entire extended duration of breastfeeding.
- Option C: Efavirenz is a key component of the antiretroviral therapy (ART) regimen for the mother, not for prophylaxis in the infant.
- Option D: Stavudine is an older ARV drug that has been largely phased out of first-line treatment protocols due to its significant and severe side effect profile.
Related Visual
- Visual 1: Flowchart: PMTCT algorithm for a breastfeeding infant, showing maternal ART, initial 6-week infant prophylaxis, and extended Nevirapine prophylaxis until cessation of breastfeeding.
- Visual 2: Infographic: Comparing the roles of different ARVs in PMTCT, clearly distinguishing between maternal treatment and infant prophylaxis.
Clinical Relevance
- Nursing practice connection: Use the key finding related to Pharmacological prophylaxis for Prevention of Mother-to-Child Transmission (PMTCT) of HIV to guide bedside assessment, documentation, and the next nursing action.
- Nurses play a critical role in educating the mother about the importance of strict adherence to both her own ART and the infant's daily Nevirapine prophylaxis.
- Counseling on feeding choices is vital. Nurses should support exclusive breastfeeding for the first 6 months while on prophylaxis, as mixed feeding can increase transmission risk.
- Monitoring for potential side effects in the infant, such as skin rash (a known side effect of Nevirapine), is a key nursing responsibility.
How to Approach the Question
- First, identify the core components of the question: 'ARV drug', 'prevent mother-to-child transmission', and the specific context 'during breastfeeding'.
- Recognize that PMTCT involves both treating the mother and providing prophylaxis to the infant.
- Differentiate between the initial prophylaxis given to all exposed newborns (often Zidovudine for 4-6 weeks) and the extended prophylaxis required specifically for the duration of breastfeeding.
- Recall or deduce that Nevirapine is the standard agent for this extended prophylaxis period.
- Evaluate each option: eliminate drugs used for maternal treatment (Efavirenz) and outdated drugs (Stavudine), and differentiate between initial (Zidovudine) and extended breastfeeding prophylaxis (Nevirapine).
Concept Tested & Keywords
- Concept Tested: Pharmacological prophylaxis for Prevention of Mother-to-Child Transmission (PMTCT) of HIV.
- Stem keywords: ARV drug, mother-to-child transmission, breastfeeding
- Lead-in keywords: Which
- Clinical cues: Age/sex group narrows the expected diagnosis, intervention, or normal reference range.
- Negative lead-in flag: false
Question ID
Q0B0bevcdhEG0O2dAhzA6Y
Practise the full AIIMS CRE 2025
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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