What is the HIV transmission risk from mother to baby?

Question

Hello doctor,

I am 31 years old and human immunodeficiency virus (HIV) positive (undetectable for the last two years), and I recently found out I am 10 weeks pregnant. I am on Biktarvy and feeling well, but I am anxious about transmission to my baby, even though my doctor says the risk is very low.

I also read online about undetectable = untransmittable (U=U), but does that apply in pregnancy, too?
Should I be switched to a different regimen during pregnancy?
And is a vaginal birth still an option?

Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

Undetectable = untransmittable (U=U) applies during pregnancy, provided you have a sustained detectable viral load. In such cases, the risk of human immunodeficiency virus (HIV) transmission is less than one percent. Vertical transmission is eliminated when the following are true. These include:

Adherent to antiretroviral therapy (ART).
Viral load undetectable.
No co-infection.
Infant receives postnatal antiretroviral prophylaxis.

Tablet Biktarvy (nucleoside or nucleotide reverse transcriptase inhibitors (NRTIs)) is not safe during pregnancy. Currently recommended as first-line therapy. Concerns are limited to data.

If the viral load remains undetectable, the affected person can have a vaginal birth.

A baby born to an HIV-positive mother needs to receive medication. The baby will receive Zidovudine injection (nucleoside reverse transcriptase inhibitor) for four to six weeks.

Kindly consult a specialist doctor, talk with them, and take medications with their consent.

I hope this helps.

Thank you.