Question

Should I terminate my pregnancy?

7 January 2011. Related: All topics, Pregnancy.

Hi

I have just discovered that I am 9 weeks pregnant and I’m currently on 3TC, d4t and Stocrin (efavirenz). My CD4 is 850 and my viral load is undetectable.

Please advise it is safe to have the child and how soon should I start the mother to child prevention treatment? Is natural birth safe or is a Caesarean section better for me? I’m confused and scared and I’m thinking of terminating the pregnancy!

Answer

Answer: Charlotte Walker

Thank you for your question.

Please don’t worry, thousands of positive women have HIV negative babies. As you are on treatment with an undetectable viral load your baby is at extremely low risk of getting HIV as HIV treatment can almost completely prevent transmission.

Any HIV treatment is prevention of mother to child treatment and so you have already started this. The only thing is that one of your treatments, the Stocrin (efavirenz), is quite controversial in early pregnancy. One animal study found efavirenz could possibly cause defects in the baby but so far this has not been seen in humans. Nevertheless efavirenz is not always recommended during pregnancy and you may want to speak to your HIV doctor about switching this drug to something else. For more information please follow this link.

As far as how to deliver the baby is concerned, this is your decision. Recent data from the UK and Ireland indicate that mothers on combination therapy with an undetectable viral load can deliver vaginally and that pre-labour Caesarean delivery does not offer any additional benefit to the babies. If you do decide to have a Caesarean section then it would need to happen before you went into labour. For more information please follow this link.

For general information about HIV, Pregnancy and Women’s Health then you should read our guidebook by following this link.

Good luck!