Answer

Thank you for your question.

Taking HIV medications should get your viral load to undetectable levels before delivery, which is what your doctors should be aiming for.

If your viral load is still detectable, then adding other HIV drugs now would be routinely done in the UK.

There are two options available to pregnant women in the UK (Canada may have its own policies but I expect they are probably similar to the UK).

1. Use Short Term Triple Antiretroviral Therapy (START). With START, you begin treatment during the second trimester at 20 to 28 weeks, and then stop after delivery. You can choose to plan a Caesarian-section at 38-39 weeks or a vaginal birth.
2. Use AZT monotherapy, without any other ARVs, and have a planned pre-labour Caesarian-section at 38 weeks.

The second option is only suitable for women with a high CD4 count and a low viral load who would not need to use ARV treatment for several years. For more information please follow this link

Although AZT is the only drug that is licensed for use during pregnancy, nearly every other commonly uses HIV drug is also used in triple combinations in pregnancy. This use is supported by good safety results. For example, AZT is often used in combination with 3TC and either nevirapine or Kaletra (lopinavir and ritonavir). AZT is more effective if used in combination with these other drugs.

For more information on which drugs to take during pregnancy please follow this link

Current recommendations state that treatment should be started at a CD4 count of around 350. If your CD4 count is 286 you may need to begin preparing yourself for starting treatment full time once you have given birth. As a new mum your health is especially important if you are to cope with a newborn. Taking medication will help you remain healthy.

For a general guidebook on ‘HIV, Pregnancy and Women’s Health’ please follow this link

Answer: Charlotte Walker