Will I need extra tests and monitoring?
Both pregnancy and HIV care require good monitoring.
For HIV you will have your viral load and CD4 carefully monitored. You may also need a resistance test.
Some doctors may recommend TDM (therapeutic drug monitoring). TDM uses blood tests to check whether you are absorbing the correct amount of a drug. Drug levels, particularly of protease inhibitors can vary greatly between individuals and tend to be lower during pregnancy. Occasionally this can lead to a dose adjustment.
In addition to your HIV care you will be screened for hepatitis, syphilis and other sexually transmitted diseases, anaemia and tuberculosis (TB). Sexually transmitted diseases and vaginal infections can increase HIV transmission.
You may also need to be screened for toxoplasmosis and cytomegalovirus (CMV). These are two common infections that can be transmitted to your baby. The tests should be performed as early as possible in your pregnancy. You should be treated for these if necessary.
Your clinic will provide a thorough gynaecological check up. This will include a cervical (Pap) smear, which is particularly important if your CD4 is below 200 cells/mm3.
Otherwise, tests will be fairly routine, and may vary slightly from doctor to doctor. Routine tests include blood pressure, weight and blood and urine tests.
Unless you need extra care you will probably visit your clinic monthly for most of your pregnancy and every two weeks after the eighth month.