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HIV and Hep B co-infection and trying to get pregnant
Jan 21, 2012

I am HIV + and Hep b + with a undetectable level of HIV since 2009 and my Hep B hovering around 600 copies down from 500,000,000. My CD4 count is in the high 700 and was never lower than 560. I take Atripla to control both. My spouse is negative on both areas with a strong Hep B titer. We are thinking of conceiving a child and want carefully evalute the risk. We believe we have a good understanding of the risk of the HIV but are concerned that with the Hep B and the risk of transmitting it to her, even though she has a demonstrated immune response. Can you please shed some light to the risk involved. Most doctors seem not willing to touch this subject in detail. So my question is have you ever seen or heard of a transmission to in this case with numbers relative to ours.

Your help is greatly appreciated.

Thanks

Response from Dr. McGovern

There are specialists who are expert in taking care of an HIV-infected women during her pregnancy and I would suggest that you find out in your area where that doctor is. You can usually find one in an academic teaching center.

I would doubt transmission of Hepatitis B would occur because your baby would be vaccinated at birth and your HBV level is very low.

However, you also need to plan to change your HIV meds around. Atripla is made of tenofovir and emtricitabine (both active against HBV) and efavirenz.

You can keep the HBV medications but you need to change the efavirenz before you get pregnant. Efavirenz is not a good drug for the first trimester of pregnancy.



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