7.2.2 First-line ART for pregnant and breastfeeding women and ARV drugs for their infants
Consolidated ARV guidelines, June 2013
- A once-daily fixed-dose combination of TDF + 3TC (or FTC) + EFV is recommended as first-line ART in pregnant and breastfeeding women, including pregnant women in the first trimester of pregnancy and women of childbearing age. The recommendation applies both to lifelong treatment and to ART initiated for PMTCT and then stopped (strong recommendation, low- to moderate-quality evidence: moderate-quality evidence for adults in general but low-quality evidence for the specific population of pregnant and breastfeeding women and infants).
- Infants of mothers who are receiving ART and are breastfeeding should receive six weeks of infant prophylaxis with daily NVP. If infants are receiving replacement feeding, they should be given four to six weeks of infant prophylaxis with daily NVP (or twice-daily AZT). Infant prophylaxis should begin at birth or when HIV exposure is recognized postpartum (strong recommendation, moderate-quality evidence for breastfeeding infants; strong recommendation, low-quality evidence for infants receiving only replacement feeding).
Note: For the recommendations on infant prophylaxis, the GRADE ratings and recommendations shown are from the 2010 guidelines and were not reviewed by the Guidelines Development Group for the current guidelines.