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unintended pregnancies
the placenta and amniotic fluid are infected there is poor maternal nutrition, especially micronutrient deficiencies the mother has a sexually transmitted infection a baby is born prematurely, before 34 weeks gestation
Influences on the risk of transmission cont Factors related to labour and delivery:
interventions such as artificial rupture of membranes, and foetal scalp electrodes, increase risk
episiotomy may increase risk and is rarely needed elective caesarean section reduces risk blood transfusion increases risk especially when blood is not screened
Exclusive breastfeeding (nothing by mouth except breast milk) has a lower risk
Breast problems such as cracked nipples, mastitis and breast abscess increase risk Oral problems in the baby, such as thrush and ulcers, increase the risk Risk higher with high viral load soon after infection with HIV; again when mother develops HIV-related illness Cumulative risk throughout duration of breastfeeding
klinis I : 1. Asimtomatik 2. Limfadenopati generalisata klinis II : 1. Diare kronik > 30 hr tanpa E yang jelas 2. Kandidiasis persisten atau berulang 3. BB (-) atau gagal tumbuh tanpa E yg jelas. 4. Demam persisten > 30 hr tanpa E yg jelas. 5. Infeksi bakteri berulang yg berat.
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1. 2. 3. 4. 5.
klinis III : Infeksi oportunistik Gagal tumbuh yg berat (wasting) tanpa E yg jelas. Ensefalopati yg progresif. Keganasan. Sepsis atau meningitis berulang.
Obat Antiretroviral (ARV) Golongan : Nucleoside RTI : 1. Abacavir (ABC) 2. Didanosine (ddl) 3. Lamivudine (3TC) 4. Stavudine (d4T) 5. Zidovudine (ZDV / AZT)
Nucleotide
RTI Tenofovir (TDF) Non-nucleoside RTI 1. Efavirenz (EFV) 2. Nevirapine (NVP) Protease inhibitors 1. Indinavir/ritonavir (IDV/r) 2. Lopinavir/ritonavir (LPV/r) 3. Nelfinavir (NFV) 4. Saquinavir/ritonavir (SQV/r) 5. Ritonavir (RTV,r)
Rejimen ARV lini-kedua : ABC + ddl + LPV/r atau NFV,atau SQV/r bila BB > 25 kg
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