Question

I’m pregnant, my CD4 is 127- do I need ARVs?

24 October 2012. Related: All topics, CD4 and viral load, Pregnancy, Starting treatment.

I’m a 5 months pregnant and have just tested HIV positive with a CD4 count of 127.
I have never been sick. I have started taking nevaripine to protect the baby.

Is it necessary/ urgent for me to start taking ARVs or can I increase my CD4 count by other means?

Please help. I am scared I will have to take the pills for the rest of my life if I start now! *confused*

Answer

Answer: Rebecca McDowall

I’m very sorry to hear about your recent diagnosis. Finding out you have HIV is never easy, but finding out when you are pregnant can be especially difficult. Do you have any support to help you deal with this?

Because your CD4 count is under 200 it’s important that you start ARVs as soon as possible. This is both for your own health and for your baby.

When your CD4 count is under 200 you are at risk of developing opportunistic infections like TB and pneumonia. The lower your CD4 falls, the higher this risk becomes. This doesn’t mean you definitely will get ill- just that it is more likely.

Starting treatment can be frightening. But HIV treatment is much better than it used to be. With effective treatment HIV positive people can live about as long as people without HIV. Being on treatment means you’re much less likely to get opportunistic infections. The treatment for those infections can be more difficult than the treatment for HIV. And the newer treatments have much fewer side effects- and those that do occur are usually easy to deal with.

Nevirapine on its own is not recommended during pregnancy for prevention of mother to child transmission. In some countries a single dose of nevirapine is given during labour to reduce the chance of transmission. But this is much less effective than putting the mother on ARVs- especially when she needs this for her own health.

For more information about HIV and pregnancy see our pregnancy guide. And for more information about starting treatment see our combination therapy guide.

Please get in touch if you have any questions!