Q and A

Question

I’m 6 months pregnant. Is it safe to delay 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.

240 comments

  1. Lisa Thorley

    Hi Zee,

    You’re pregnant, so you need to be on ARVs. This is because it’s the ARVs that will help reduce the risk of transmission to your children. Please see here: http://i-base.info/guides/pregnancy

    Because you’re pregnant, you should be under specialist care. If you aren’t then this is something that you’ll need to look into. This is important, because other than having HIV, you’re also carrying twins and twins usually don’t go full term.

    It is possible that you can get your HIV under control before you give birth, you do however need to start and start ASAP.

  2. Zee

    Im 5 months pregnant with twiñs, im worried about transmission to my unborn babies. I haven’t started taking any treatment to protect them. Will they get infected.

  3. Lisa Thorley

    Hi Anonymous,

    When thinking about mother to child transmission, what’s important is the mothers viral load, not the CD4 count. As long as your viral load is undetectable by the time you’re due to give birth, the risk to your child will be minimal. Please see here: http://i-base.info/guides/pregnancy

    Breastfeeding guidelines vary depending on where it is that someone lives. In the UK women aren’t advised to breastfeed.

  4. Anonymous

    I’m positive and 22 weeks my cd4 count is low I take my arvs everyday…I want to breastfeed and deliver natural will my child be positive

  5. Roy Trevelion

    Hi Unam,

    The good news is that benefits of ARVs are not just to your own health. Treating your HIV will reduce the risk of your baby becoming HIV positive to almost zero. So taking ARVs sounds like you’re doing all you can to protect your child. The aim of taking ARVs is to get viral load to undetectable before it’s time to deliver your baby.

    Do you have access to your viral load results? And what does your doctor say about your CD4 count? Please let us know.

    Here is the guide to HIV pregnancy and women’s health. There’s a lot of info in this, including for after your baby is born.

  6. Unam

    Hello I’m 5 months pregnant nd also HIV positive and I’m on treatment (Odimune) is this ARVs going to protect my child from hiv plz help my CD4 is 164

  7. Lisa Thorley

    Hi Nasiphi,

    If you’re pregnant you need to tell your doctor, this is because you should if possible be given specialist care.
    As you’re already on medication, you’re doing the best thing possible for your child as well as yourself. Please see here: http://i-base.info/guides/pregnancy

  8. Nasiphi

    hi I’m HIV and 2 months pregnant I take arvs every night but I didn’t tell my doctor about pregnancy am worried what is effected already

  9. Roy Trevelion

    Hi Lattie,

    First, congratulations on the news that you’re going to have a baby. And it’s great that you’re taking your meds each and everyday. So it sounds like you’re doing all you can to protect your baby from HIV.

    But what does your doctor say about your viral load result? The aim of HIV treatment (ART) is to get viral load to less than 50 copies/mL by the time your baby is born. Have you been on ART for long? Please also tell us what your previous viral load results have been.

    Please see this guide to HIV pregnancy and women’s health.

    If you live in South Africa you can contact the Treatment Action Campaign (TAC) at this contact link. TAC can help with local support.

    Please let us know how you get on.

  10. Lattie

    Hi. I am HIV positive pregnant woman. Last month my viral load was 1070. But I am also taking my meds each and everyday. Will my unborn baby be infected? Please help I am very worried. So this month I am going to do the blood test again

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