Is pregnancy safe for HIV-positive women at 24?

Question

Hi doctor,

I am a 24-year-old HIV-positive patient who is eight weeks pregnant. I want to know

If pregnancy is safe during HIV.
Can HIV be transmitted to my baby?
How can I prevent HIV transmission to the baby?
What care should be taken to avoid HIV transmission to the child?
Is there any specific treatment for HIV-positive pregnant women?

Please help.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I read your query and can understand your concern.

Well, I am deeply concerned about your worries. I understand that you are in a tough time and I am here to help you. Well, yes it is safe to have a pregnancy and you can follow the suggested plan. I am giving you suggestions about pre-conception care which includes

MDTA (multidisciplinary team advice) - This includes an obstetrician, physician expert in HIV (human immunodeficiency virus), psychiatrist, and psychotherapist. You can check all these doctors. Take Folic acid 5 mg pre-conception till the first three months of pregnancy. You should do a CD4 count and it should be less than 50 cells/mm and the viral load should be less than 200 copies/ml. You should continue taking anti-retroviral therapy.
Antepartum care - You should do OGTT (oral glucose tolerance test) because ARVT causes diabetes in pregnancy. Fasting plasma glucose should be 5 mmol/l up to 7 mmol/L, and plasma glucose level should be 4 mmol/l up to 7 mmol/l. You should repeat CD4 count and viral load load every month. You should continue taking medication for HIV during pregnancy which is Zidovudine (ZVD), Lamevidine Nevilapine. You should repeat OGTT at 24 to 28 weeks of pregnancy.

You should do a dating scan between 11 and 13 weeks of pregnancy, an anomaly scan at 18 to 22 weeks, growth scan at 28, 32, and 36 weeks. You should repeat the CD4 count and viral load at 36 weeks to decide the mode of delivery.

If the CD4 level remains less than 50 cells/mm then we can do spontaneous vaginal delivery. When labour starts we will start IV (intravenous Zidovudine) ZVD till delivery.

If the CD4 level is more than 50 cells/mm we will plan to have an electro-cesarean section due to maternal fetal risk transmission. We will start IV ZVD at the start of the cesarean till cutting the umbilical cord.

At post-delivery, we will give the baby post-delivery prophylactic dose. We will do a blood test and cord blood test of the baby. Then we will repeat after three days. Then we will do PCR (polymerase chain reaction) at three weeks, three months, six months, and eighteen months. Then we will shift the patient back to the HIV physician.

I hope I made an effort to clear up your question. If you have any further queries please do not hesitate to contact me. I would appreciate it if you can give your feedback.

I hope this helps.

Thank you and take care.