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Question on past response
Apr 11, 2001

On a past question "Having a baby" March 28, 2001 post you said that with an undetected viral load a c-section is not advisable, I was wondering why? My doctor told me that if I decide to have a baby she would have me deliver c-section and that she has had her other patients with hiv in the past deliver that way with no complications. I am currently on combivir, viramune, valtrex and paxil with an undetected viral load and tcell of 566 (usually between 550 and 700), would any of this be a concern? Thank you.

Response from Dr. Luzuriaga

The risk of mother-to-child HIV transmission when the mother's viral load is undetectable is < 1%. Because the risk is so low and C-sections do carry some risk of maternal complications and infection, the current guidelines (which I agree with) recommend C-section only for women with viral load > 1000 at delivery. Copies of the "Guidelines for the Use of Antiretrovirals in Pregnant Women" are available on this web site under the Guidelines section. You should certainly discuss the issue of a C-section with your provider and go with what you and your provider feel comfortable with.


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