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 Elizabeth,
Give yourself a minute to breath. You aren’t going to die from HIV. Your CD4 is OK, and it’ll increase over time. You being undetectable is great news. This means that the risk of transmission is much lower than if you weren’t on meds. For more info about this and pregnancy please see here:
http://i-base.info/guides/pregnancy
With regards to not having told anyone, this must be hard. Isn’t there a friend you could talk to, or a support group near to where you live?
Though there may be a lot of stigma associated with HIV, there are a lot of people who are fine with it.
If you think you may have contracted HIV from your childs father, he may not know about his status. Therefore, its up to you if you want to tell him about yours.
Hi. I found out about my HIV status when I was 3 months pregnant (1st pregnancy ) and 2 days later I started ARVs. I never disclosed my status to anyone because at home they always say names about HIV + people so I feel like they’ll definitely isolate me and my baby once he arrives .
When I was 4 months I had an unprotected sex with my baby dad I’m not sure if he’s aware about his status as I haven’t told him anything about mine and 1 thing for sure he doesn’t take ARV’s.
My viral load is undetectable and my CD4 count is 345 will my baby boy get infected? I’m scared I’m going to die.
Hi Brown,
If you’re on meds that are OK during pregnancy then you won’t need to change. If you did need to change, how this would be done would depend on where you live.
With regards to giving birth, if you’re undetectable then you’ll be able to have a normal birth. Once you give birth your baby will be given medication. I can’t say how this would be done, be it private or public.
Hi guys, I’m already on my meds, its been 4 years now. For now all is going well. Now just discovered am 14 weeks pregnant, would a private doc or gynecologist offer all Meds that will br needed when going 4 delivery in a private hospital??
Hi Lizzy,
How are you coping with your diagnoses? Are you able to get any support?
Being on meds is the best thing that you can do in terms of reducing the risk of transmission to your baby. As to whether they will be OK or not, no one can answer this. However, you being on meds will help, and help a lot. For more info, please see here:
http://i-base.info/guides/pregnancy
Hi, I’m pregnant I started to take my meds when I was 6 month pregnant. I didn’t know that I had HIV. I take them every day. Will my baby be OK?
Hi Vivian,
The combination that you are on is perfectly fine during and after pregnancy.
Hi Lisa
Thanks for a quick response, adco-Emtevir is a generic for truvada. So I take adco-Emtevir with edurant.
Hi Vivian,
Other than the rilpivirine, (Edurnat) what else are you taking? Adco-emtefer isn’t something that I recognize.
Hi guys
Im 6weeks pregnant and HIV positive. Im taking edurant and adco-emtefer. Are they safe for my unborn baby.