AIIMS CRE 2025
Pharmacology
Medium
Which ARV drug is included to prevent mother-to-child transmission during breastfeeding?
Appeared in: AIIMS CRE 2025
Explanation
- Nevirapine is a non-nucleoside reverse transcriptase inhibitor (NNRTI) used for infant prophylaxis to prevent mother-to-child HIV transmission.
- It is particularly indicated in regimens for high-risk infants, where the risk of transmission (including through breastfeeding) is elevated.
- While maternal viral suppression is the primary goal, infant prophylaxis with drugs like Nevirapine provides an essential secondary layer of protection.
- Global health guidelines (like WHO) have historically recommended daily Nevirapine for the infant throughout the breastfeeding period in resource-limited settings.
Why Other Options Were Wrong
- Option A: Zidovudine is used as a standard, short-term (2-6 weeks) prophylaxis for all HIV-exposed newborns, not specifically for extended protection during breastfeeding.
- Option C: Efavirenz is a component of adult and older children's ART regimens but is not recommended for neonatal prophylaxis due to potential CNS side effects and lack of dosing data for newborns.
- Option D: Stavudine is an older drug that is no longer recommended for use due to its high rate of severe and irreversible side effects, such as lipoatrophy and peripheral neuropathy.
Related Visual
Clinical Relevance
- Nursing practice connection: Use the key finding related to Antiretroviral (ARV) prophylaxis for Prevention of Mother-to-Child Transmission (PMTCT) to guide bedside assessment, documentation, and the next nursing action.
- Nurses play a crucial role in PMTCT by providing non-judgmental, evidence-based counseling to mothers about ART adherence, infant feeding choices, and the importance of infant prophylaxis.
- Patient education is key. The nurse must ensure the parent can correctly administer the medication to the infant and understands the follow-up schedule for both themselves and the baby.
- What if the mother's viral load is unknown or detectable (>1,000 copies/mL) at delivery? The infant is considered high-risk. This mandates immediate initiation of a multi-drug presumptive HIV therapy regimen, which often includes Zidovudine, Lamivudine, and Nevirapine, instead of just Zidovudine monotherapy.
How to Approach the Question
- First, identify the key concepts in the question: 'ARV drug', 'mother-to-child transmission', and 'breastfeeding'. This points to infant prophylaxis.
- Differentiate between antiretroviral therapy for the mother and prophylaxis for the infant. The question is about the infant.
- Recall the standard drugs used for infant prophylaxis. Zidovudine and Nevirapine are common, while Efavirenz and Stavudine are not used for this purpose.
- Differentiate the roles of Zidovudine and Nevirapine. Zidovudine is the standard short-term prophylaxis for all. Nevirapine is often added or used in specific high-risk scenarios or for extended prophylaxis related to breastfeeding.
- Eliminate Stavudine as it is an outdated drug with severe toxicity. Eliminate Efavirenz as it is not used in neonates. Between Zidovudine and Nevirapine, Nevirapine is the drug specifically associated with breastfeeding prophylaxis in many guidelines.
Concept Tested & Keywords
- Concept Tested: Antiretroviral (ARV) prophylaxis for Prevention of Mother-to-Child Transmission (PMTCT)
- Stem keywords: ARV drug, prevent 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
Reference Book
E6 Nelson Textbook of Pediatrics(2024) — Volume 1 pp. 2120-2122, 2106-2108
E6 Pharmacology Katzung 16e p. 1357-1359
Practise the full AIIMS CRE 2025
Attempt every question from this paper in a timed mock, then review the full solution for each one.
More Antimicrobial Drugs Questions
- Patient is allergic to Beta-lactamase and which of following drug is safe to administer?
- A nurse is advised to administer inj. Metronidazole to a patient. She knows action of this is:
- Which of the following antitubercular medication has the side effect of Peripheral neuritis?
- A first line medication for pulmonary tuberculosis:-
- Disulfiram is a drug used in treatment of
- Which of the following antitubercular medications has the side effect of Pinkish orange color urine?
- Whole virus inactivated vaccine of COVID-19 is?
- Patients with tuberculosis who are on isoniazid therapy should also be administered?
- Which antibiotic is known as first wonder drug?
- A patient with tuberculosis who is on isoniazid therapy should also be administered?
More AIIMS CRE 2025 Questions
- What is the preferred first-line ART regimen for HIV-infected adults?
- Which action reduces the risk of mother-to-child transmission of HIV during childbirth?
- Which antiretroviral regimen is recommended for newborns exposed to HIV?
- What is the duration of ARV prophylaxis for newborns exposed to HIV?
- What is the recommendation for ARV treatment in HIV-positive pregnant women during labor?
- PEP (Post-exposure prophylaxis) after needle-stick injury should be initiated within:
- How long should post-exposure prophylaxis (PEP) be continued after potential HIV exposure?
- Which body fluid is most likely to transmit HIV through a needle-stick injury?
- Recommended HIV follow-up testing schedule for healthcare workers after needle-stick injury is:
- Which statement about post-exposure prophylaxis is true?