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Help -- when to have a baby?
Aug 13, 2000

Hello. I read today on this site that if a woman gets infected during or just before pregnancy the chance for the baby to get infected can be up to 50%! I've also read that with the medication, and AZT it can be only 5%....

Now, I'm an HIV neg woman who is trying to have a baby with her HIV pos husband. I acknowledge the risks, and that is why we decided to try it when his virals are undetectable to 'minimize' them...IF I do get infected and get pregnant, does this mean my baby has 50% of a chance to get infected with HIV...even if I take all the neccessary medication?

If I get infected just before getting pregnant, how close is too close for the infection to be high risk for the baby?. Please help, I'm confused by all this new information I read today!!! Thank you.

Response from Dr. Jackson

If a woman is pregnant and becomes HIV infected during her pregnancy the risk may be as high as 50% because the viral load during acute infection is initially very high often in the millions of HIV RNA copies/mL. It is not known what the risk is of infecting a fetus if a woman becomes HIV infected at the time of conception or just before conception, but there is probably a higher risk than for a woman who has a stable relatively low HIV RNA viral load which is common in chronic HIV infection. However, HIV transmission to yourself and to your fetus can be minimized if your husband's viral load is undetectable and if you were to take antiretrovirals around the time of conception. The problem is that the antiretroviral may have an adverse effect on your ability to conceive or possibly have an adverse effect on the developing fetus if you were to take an antiretroviral around the time of conception. Nevertheless, many women have become pregnant while on antiretrovirals and delivered healthy babies. You should note that antiretrovirals are not licensed for use in uninfected women who are trying to get pregnant as the risks are really unknown. In any case the risk of your husband transmitting HIV to you if he has an undetectable viral load is very very low, but not zero.

Brooks Jackson, M.D.

adoption of a baby from a positive mother
icsi or artificial insemination

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