Question
Pregnant and newly diagnosed, do I need to take ARVs?
4 January 2015. Related: All topics, Newly diagnosed, Pregnancy, South Africa.
Hi,
I am pregnant and I just found out that I have HIV. My CD4 is 754.
Should I take ARVs?
What will happen when if I stop the meds after delivering my baby?
If I terminate this pregnancy will I be at risk?
Answer
I’m very sorry to hear about your recent diagnosis.
Finding out you are HIV positive is never easy but finding out while pregnant can be especially hard.
However, it is much better that you found this out now so that you can use ART.
It might also help to know that many women have been through this before. You are not on your own – there are services and care available to help you.
You asked several questions so I will go through each of these one at a time.
Your asked whether you need to take ARVs?
In 2016, most treatment guidelines recommend HIV treatment (ART) for anyone who is HIV positive. This includes during pregnancy.
ART is recommended both for your own health and to prevent transmitting HIV to your baby.
In the UK most pregnant HIV positive women will take three HIV drugs. The choice of drugs will depend on your health and other foctors.
It is generally recommended to continue ART after birth. However, guidelines vary in different countries. Your doctor should be able to tell you what the guidelines are where you live.
You asked what will happen if you stop the meds after delivering your baby.
Your baby should continue to receive treatment for four weeks after birth. If you are breastfeeding you will need to continue to take ART.
Because your CD4 count is so high, if you need to stop treatment at the end of this time, this is also okay. This was the practice for many years.
Guidelines generally now recommend staying on ART though.
You also asked whether you would be at risk if you terminate this pregnancy?
For this I would first ask whether there is a reason why you are considering an abortion, also known as TOP (termination of pregnancy).
Is it because you are worried that the baby may be born positive? If that is the main reason why, then it might be useful for you to know that with access to ART, plus care and support, most women living with HIV have healthy babies that are HIV negative.
It may be, however, that you already have the information above and this is a decision you have chosen to go ahead with for other reasons.
In this case, an abortion should not carry any more risks than it would for an HIV negative woman. This is dependent on the abortion being carried out using the right procedures, in a hospital and with the right treatment and care.
This answer was updated in January 2016 from a question posted on 11 May 2012.
Hi Nelao,
I’m sorry to hear how worried you are. Do you have any support to help you deal with this stress?
It’s important that you see a doctor and discuss HIV treatment. Whether you need this for your own health or not right now it’s important that you get treatment to prevent your child being infected.
It’s very understandable that you are confused. Although it would be very unusual it is possible that you could have been positive for 19 years without knowing it. Unfortunately it’s unlikely you will ever know for sure how or when you were infected. The important thing for now is to get the treatment you need to keep both you and your child healthy.
For more information please see our guide to HIV and pregnancy.
Hai my name is Nelao an am 20 years old. i found out that am hiv+ last year when i donated blood. confusing part is that i dont knw how i might goten it if i never took part in any sexual activities before. so that means i have been living with it for 19 years without knowing it. am neva sick except for the cold an flus an headaches but can go 4 even 2 years without visting the clinic. am now 4 months pregnant an al i want is to do whats best for my child.what should i do?am scared to death.
Hi Lwazi,
I’m not surprised you are confused! It can be very difficult when you get different information from different doctors. Rather than confuse you further by giving you lots of information I suggest reading this page in our pregnancy guide: What if I do not need treatment for my own HIV?
This explains clearly the different options for treatment and delivery that are available to you. The emphasis is on the word options – because your CD4 count is high and you are receiving treatment early in pregnancy you should be allowed to decide which treatment and which delivery method you prefer. Please read the page above and let me know if you have any questions.
To understand the different advice you have been given about breastfeeding please see this previous question. Again, let me know if you have any questions.
my name is Lwazi. im 23weeks pregnant and hiv+ my cd4 is 567 and my gynae prescribed Aluvia and Lamzid. when i visited the clinic they suggested azt.
gynae advised i shouldnt breast feed but the clinic is actively promoting brestfeeding.im now really confused. the gynae strongly suggested csection but clinic says natural. whats the safest option and which drugs should i continue with. this is really hard.
Hi Nosipho,
The weakness you are feeling may be a side effect of starting treatment- this should improve after the first few weeks on treatment. You can read about efavirenz side effect in our side effects guide. But it is important that you talk to your doctor about this weakness, and the other symptoms you mention.
Its been a month since i started the treatment.
Hi Nosipho,
How long have you been on treatment? It’s important to talk to your doctor about any symptoms, and to show them these boils and candida. Dizziness can be a side effect of efavirenz and this may be why you are feeling weak. But boils and candida may suggest another infection which may need separate treatment which is why it is important you speak to your doctor about this.
I was recently diagnosed with a cd4 count of 273 and i started taking arv (tenofovir…, lamivudine and Efavirenz) but i have been getting weak, boils and candida
Hi Tshepi,
I’m sorry to hear about your recent diagnosis. Do you have support to help you deal with this?
ARVs are recommended for anybody with a CD4 count under 350. Taking ARVs can also reduce the chance of transmitting HIV to your baby. Because you are on AZT already your doctor will probably give you two more anti-HIV drugs to take with AZT.
‘Norstan isoniazid’ is used to prevent you from getting TB. These drugs can interact with some ARVs (such as d4T) so your doctor should check for interactions before you start treatment. But there are many ARVs that can be taken with isoniazid so this is not a reason not to start treatment.
I’m 7 months pregnant and found out last month that I’m HIV+ and my CD4 count it 182. I’m takin AZT pils and Norstan pills. So I want to know if a will take ARVs even I’m takin those medicines?