Q and A

Question

My girlfriend and I have herpes. Can we conceive naturally?

I am HIV positive and my viral load is less than 40 so I am undetectable. My CD4 count is 534.

Will my CD4 count ever go up?

I also wanted to know that since I am HIV positive and I have herpes as well and my girlfriend does too, what are our chances of having a baby naturally without passing it to my negative girlfriend or the baby?

Both of our herpes are suppressed.

Answer

You have asked a  couple of questions so I will respond to them one at a time.

Your first question was whether  your CD4 count would ever go up. It’s great that you currently have an undetectable viral load and with a CD4 count of 534, a strong immune system. Although you did not specify it, with an undetectable viral load, I am assuming that you are taking ARVs (antiretroviral treatment for HIV). If this is the case, then generally your CD4 count would increase as ARVs are the only proven way of increasing CD4 count.

Your second question was what your chances are of having a baby naturally without passing HIV onto your negative girlfriend and unborn baby. It’s good that you and your girlfriend are looking to the future and planning to have a baby. Many sero-different couples (where one is positive and the other is negative) have had and continue to have healthy HIV negative babies.

Your chances of having a baby naturally without passing on HIV to the baby are dependant on a number of factors including whether you are on treatment and how adherent  you are to your medication. Adherence refers to taking your medication exactly as prescribed. It includes taking them on time and following any dietary advice. Taking ARVs and having an undetectable viral load dramatically reduces the risk of passing on HIV to your girlfriend and the unborn baby.

You mention that you and your girlfriend have suppressed herpes. Unfortunately, the presence of STIs (Sexually Transmitted Infections) including herpes, can increase the risk of transmission of HIV. Herpes could also be passed on to the baby during delivery. As your herpes is suppressed, it is important to ensure that you are both monitored and treated, should the herpes re-occur. Should the herpes re-occur, the good news is that  can be easily treated using acyclovir.

Please follow this link to the Swiss Statement which explains in more detail, the conditions that need to be present for sero-different couples wishing to conceive naturally.

You may also find it helpful to read our guide to HIV pregnancy and women’s health which provides information on conception options for a couple like you.

Finally, it will be good for you both to discuss your plans to conceive naturally with your doctor as he/she will be able to advice you accordingly.

Best wishes.

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