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HIV prophylaxis during pregnancy
Sep 22, 2005

I am a healthcare worker who was recently had a needlestick from an HIV positive patient. My exposure was a pin prick through a glove with a large bore needle, with very little bleeding when attempted to bleed it. I am also in the early stages of pregnancy. I have been put on Combivir and Kaletra for PEP. Will these drugs have any teratogenic effects on my baby? How effective is this combination in prevention of HIV? I was told that the source's viral load is undetectable. Resistance to any other medications is unkown at this time. However, the regimen that the source is on led my provider to believe that there was some resistance in the past. Thanks in advance.

Response from Dr. Young

Thanks for your post.

I'm sorry to hear about your possible exposure. If the source's viral load was undetectable, your chances of infection from this patient and type of exposure should be very low.

The combination of Combivir and Kaletra is certainly very potent and is generally considered safe during pregnancy. Further, boosted PIs tend to avoid issues with transmitted drug resistance, mitigating this concern. A recent publication from the late Dr. Ann Morris analyzes the safety of protease inhibitors during pregnancy and suggest that all are generally safe and well tolerated in this setting, with no obvious risk of teratogenicity.

Good luck, BY

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