Question
Do I need to start treatment if I'm planning to have a baby?
18 April 2012. Related: All topics, Pregnancy, Sero different couples, Starting treatment.
I have just been diagnosed with HIV, my partner of one year tested negative.
I am not on treatment. My viral load is 2790 and my cd4 count is 567.
If I want to get pregnant do I need to start treatment and do I need to continue taking medication for the rest of my life?
Answer
Firstly, I am sorry about your recent HIV diagnosis. Are you in contact with support groups for people living with HIV? Many find it helpful to share experiences and ways of coping with a new diagnosis.
It is good that you and your partner are looking to the future and planning to have a baby. Many sero-different couples (where one is HIV positive and the other is negative), have had and continue to have healthy, HIV negative babies.
With a CD4 count of 567, your immune system is still strong. There is therefore no immediate rush for you to start treatment. Both the BHIVA (British HIV Association) and the WHO (World Health Organisation) guidelines for treatment recommend starting with a CD4 cout of 350.
However, if you did get pregnant, you would need to take treatment ARVs (antiretroviral treatment for HIV). You will need to take ARVs for the duration of the pregnancy and until after the baby is born. The aim of taking ARVs is to ensure that you achieve and maintain an undetectable viral load throughout your pregnancy till the time you deliver. Viral load refers to the amount of virus in your body. An undetectable viral load (below 50 copies) means there is very little virus in your body and is therefore the best way of preventing transmission to the baby.
As treatment is individualised, whether or not you continue with treatment after the pregnancy will depend on a number of factors including: your CD4 count when you started treatment; how you feel about continuing treatment and sometimes on the treatment guidelines in the country where you live.
For more information, you may find it useful to read our guide to HIV pregnancy and women’s health. It answers a lot of general questions you may have around HIV and pregnancy. The guide also provides information on conception options for couples like you.
Good luck with your future plans.
Congratulations on your pregnancy – I hope this is all going well.
Being on treatment is likely to keep you healthy for a long time – and your CD4 count is very strong. Treatment also dramatically reduces the risk of passing HIV to your baby during pregnancy. It also reduces the risk of your boyfriend becoming HIV positive.
For the future, this might be a reason to start using condoms, even though the risk to him are now low.
Your doctor should talk to you about the extra importance of taking your HIV meds though pregnancy. Sometimes, depending on which HIV meds you are using, the dose may be changed during pregnancy. This might help your viral load become undetectable, but this is something to talk to your doctor about.
I am 27 years old and I have been on ARV for 3 years now. Recently, I found I am pregnant and my boyfriend is negative. My CD4 count is 509 and my viral load is 159. Have I infected both the baby and my boyfriend?