Foreword
It is my great pleasure to introduce a new name for the programme that was formally known as Prevention of Mother-to-Child Transmission of Transmissible Infections, the name stigmatising the mother as being responsible for the infant being infected. From now onwards the programme will be called the Vertical Transmission Prevention (VTP) programme. This guideline will be a component of the Materni
It is my great pleasure to introduce a new name for the programme that was formally known as Prevention of Mother-to-Child Transmission of Transmissible Infections, the name stigmatising the mother as being responsible for the infant being infected.
From now onwards the programme will be called the Vertical Transmission Prevention (VTP) programme. This guideline will be a component of the Maternity Care guidelines and the National Consolidated ART guidelines. Furthermore, it will include recommendations from the PrEP guidelines for use of PrEP as an HIV prevention intervention for HIV-negative pregnant and breastfeeding women, the STI guidelines for screening and management of pregnant women with syphilis, and the viral hepatitis guidelines for screening and management of pregnant women with viral hepatitis B.
All pregnant and breastfeeding women must be on DTG-based regimens unless contraindicated to ensure that they are virally suppressed as soon as possible to prevent vertical transmission.
Viral load monitoring and management of elevated viral loads remains key in preventing vertical transmission of HIV. Clinicians are reminded to monitor the viral load as per these guidelines and use the EGK codes appropriately for monitoring of maternal viral load coverage and suppression rates.
Early infant diagnosis and timely treatment are critical in reducing mortality under 1-year; hence clinicians are reminded to continue testing HIV-exposed infants at birth, 10 weeks, and six months. Clinicians are further reminded that the HIV test at 18 months of age is universal, meaning all infants, regardless of HIV exposure, must be tested for HIV at 18 months.
Integration of services remains critical in achieving better health outcomes and this guideline provides resources to guide integration, especially with EPI services and maternal contraception, to enhance follow-up of HIV-exposed infants and support continued engagement in care.
I urge all clinicians at PHC clinics, community health centres and hospitals across the board to use these guidelines diligently to offer quality, comprehensive services to the public.
I would like to sincerely thank all the internal and external stakeholders who actively contributed to developing these guidelines.
South African National Department of Health, Guideline for Vertical Transmission Prevention of Communicable Infections, Version 2_August 2023