Question
I’m 6 months pregnant. Is it safe to delay starting treatment?
5 February 2018. Related: All topics, Pregnancy, South Africa, Starting treatment.
I am 6 months pregnant and have just tested positive. My CD4 count is 256. I have to start now.
I didn’t get much info as I thought I am doing it for my baby but I find it difficult to deal with the fact that I have developed AIDS, and have to start treatment.
My question is, will it be dangerous for me to delay taking the treatment for myself and only take the one for the baby. Since I think it was my emotional state that made my CD to be low.
I am very healthy and eat well. Please advise.
Answer
Firstly, congratulations on your pregnancy.
I am sorry about your recent HIV diagnosis. I can appreciate that it cannot be easy dealing with a diagnosis during pregnancy and then knowing that you need to start taking treatment straight away. Can I ask if your doctor has put you in contact with support groups for people living with HIV? Many women find it helpful sharing experiences and coping with being HIV positive and pregnant.
Technically, a CD4 count of 256 doe not mean you have ‘AIDS’ as the US defines this as being less than 200, but it does mean starting treatment is very important.
Your doctor is giving you good advice. Starting treatment (ART) straight away is important.
The WHO (World Health Organisation) guidelines recommends all HIV positive pregnant women start ART. This is regardless of the CD4 count. These meds will be good for your health and good for your baby. The meds should get your viral load to undetectable befire your baby is born. Sometimes this takes longer than three months.
Viral load refers to the amount of virus in your body. An undetectable viral load (below 50 copies) means that there is very little virus in your body and is therefore the best way of preventing transmission to the baby.
Continuing ART afterwards is also recommended, but should be discussed with your doctor. As your CD4 count is 256, it is better to continue taking treatment after the baby is born.
The good news is that ART should increase your CD4 count. Although sometimes if you start taking treatment in pregnancy your CD4 count may not increase very much. If this happens, don’t worry, your CD4 count will catch up after the baby is born. For more information on HIV and pregnancy, please follow this link to our guide to HIV, pregnancy and women’s health. The guide also answers a lot of general questions about HIV and pregnancy.
It is good that you eat well and lead a healthy lifestyle. Avoiding stress, eating a balanced diet and taking exercise are all good for your general health and well being. However, this will not necessarily increase your CD4 count. ARVs are the only proven way of increasing and maintaining a good CD4 count.
As you are based in South Africa, you may find it useful to contact TAC (Treatment Action Campaign). They will be able to put you in contact with support groups near you. You may also find it useful to read TAC’s guide to Pregnancy in our lives.
Good luck for the rest of your pregnancy.
Note: This answer was updated in February 2018 from a question first posted online in April 2012.
Hi Ella, It’s good to hear that you’re having a baby and that viral load is undetectable. In the UK, guidelines recommend bottle feeding. But in countries where mothers don’t have access to formula and clean bottles, the WHO (World Health Organisation) guidelines recommend that if a woman is taking HIV treatment (ART), then she should breastfeed exclusively for 6 months. After 6 months the baby can then be weaned onto a safe diet without breastfeeding. You can read more about the safest way to feed your baby on this question here.
Hi im few weeks pregnantwith a negetive husband, i have been on arv for about 5 months with undetactable virus and above 600 cd4,-im planning to breast feed my child, how lpng should i do that what dos n dont while breastfeeding him or her?
Hi Jenny, Congratulations on having a healthy baby girl. It’s good that you started meds and that your baby took them too. It’s also good that you are not breastfeeding her. Can you talk to the doctor about your worries? There is more info here about testing babies for HIV. It’s a good idea to discuss this with your doctor.
I came to learned that i am hiv positive when i was 6months pregnant my cd4 count was 569 so i started taking medicine. my baby was born through c_section weighing 3’6 kg and im not breastfeeding her. She took medicine for 3 months too and now she is 4 months old and very healthy she weigh 7’3 kg now but haven’t tested for hiv. Iam afraid . Is there any chances she is infected too?
Hi Busi, As Angelina says above, guidelines say that all HIV positive pregnant women should start HIV treatment (ART). Many women have taken ART during pregnancy and have had healthy HIV negative babies. It’s important that you talk to the doctor about ART soon.
I am 5 months prgncy and I didn’t Tk treatment for HIV so I can Tk a treatment to protect my baby???
Hi Kamogelo,
If you choose not to take ART you are putting your child’s life at risk. This is because the chances of transmission are drastically increased.
All women who are positive and are aware of their status should be on ARVs. There’s more about this here:
http://i-base.info/guides/pregnancy
Hi am Kamogelo
Am HIV positive and 4 months pregnant. If I dont take ARV at all is my unborn baby gonna be infected?
Hi Asanda,
With regards to your baby, you need to be on ARVs. This is because its the ARVs that will reduce the risk of transmission. Second line ARVs do the same thing as first line.
With the cholesterol, this should be monitored by your doctor.
For more info on HIV and pregnancy, please see here:
http://i-base.info/guides/pregnancy
I’m HIV positive and 5 months pregnant,my viral load is very high and my CD4 is low because I defaulted,the clinic doctor did not refer me to second line of treatment bcz I hv a high cholesterol,can my baby be affected?