| HIV Clinical
Performance Measure: # 17 |
| Stated
Performance Measure: Percentage
of infant clients born to women with HIV
infection who were placed on prophylaxis
for HIV and PCP |
| Numerator: |
Number
of infant clients born to women with HIV
infection who were:
- seen within the calendar year of
interest, and
- placed on prophylaxis for HIV and
PCP[1]
|
| Denominator:
|
Number of
infant clients born to women with HIV
infection who were seen within the calendar
year of interest |
| Data
Sources: |
- CADR, Section 5, Item 53d may provide
data useful in establishing a baseline
for this performance measure
- Electronic Medical Record/Electronic
Health Record
- CAREWare, Lab Tracker, or other electronic
data base
- HIVQUAL reports on this measure for
grantee under review
- Medical record data abstraction by
grantee of a sample of records that
is negotiated with the OPR Review Team
|
| National Goals, Targets,
or Benchmarks for Comparison |
IHI Goal: 100%[2] |
| Basis
for Selection: |
|
Studies show a reduction in risk of
maternal-child transmission of HIV if
an infant of an HIV positive mother is
given a 6-week course of ZDV starting
6 to 12 hours after birth.
“The highest incidence of PCP in
HIV-infected children is the first year
of life, with cases peaking at age 3-6
months… Since publication of the
1995 PCP prophylaxis guidelines recommending
initiation of primary PCP prophylaxis
in all infants born to HIV-infected women
for the first year of life (or until lack
of HIV infection is documented)…,
PCP has become unusual among HIV-infected
infants born to women who know their HIV
serostatus during or soon after pregnancy.”[3] |
| US Public
Health Guidelines: |
- To reduce the risk of transmission
of HIV from a mother with HIV-1 infection,
the newborn should be given) a six week
course of ZDV. ZDV should be initiated
as soon as possible after delivery—preferably
within 6-12 hours of birth
- To prevent P. carinii pneumonia,
all infants born to women with HIV-1
infection should begin prophylaxis at
age 6 weeks, after completion of the
ZDV prophylaxis regimen” [4]
(10/12/06)
|
| References/Notes: |
1
Prophylaxis for HIV is defined as a full
6-week course of oral Zidovudine (ZDV),
usually begun 6 to 12 hours after birth.
Prophylaxis for PCP (pneumocystis carinii
pneumonia) is defined as treatment with
the combination of drugs trimethoprim and
sulfamethoxazole (or their pharmacological
equivalent) starting at about 6 weeks and
continuing until baby is confirmed HIV negative.
2 IHI Measure
reads, “Percent of Pediatric Patients
Prescribed Prophylactic Therapy According
to Immunologic Status” (Note, this
is a related but different measure as it
looks at MAC and PCP prophylaxis, not HIV
prophylaxis.)
(http://www.ihi.org/IHI/Topics/HIVAIDS/HIVDiseaseGeneral/Measures/PercentPediatricPtsPrescribedProphylacticTherapyAccordingtoImmunologicStatus.htm)
3 Treating
Opportunistic Infections Among HIV-Exposed
and Infected Children (http://aidsinfo.nih.gov/ContentFiles/TreatmentofOI_Children.pdf)
4 Recommendations
for Use of Antiretroviral Drugs in Pregnant
HIV-1-Infected Women for Maternal Health
and Interventions to Reduce Perinatal HIV-1
Transmission in the United States (http://aidsinfo.nih.gov/ContentFiles/PerinatalGL.pdf,
Page 35) |
