i have just discovered i am 5weeks pregnant,i am not on ARV,but i am on Aciclovir 400mg twice a day when i need them, my main concerns are whether my baby would be harmed by Aciclovir and whether or not i should start taking medication now, would HIV medication be safe for my baby?

Thanks for your post.

First off, it's important to consider the risks and benefits of medications during pregnancy, particularly during the first trimester.

If you need to use it, acyclovir should be safe to use.

As for antiretroviral medications, if your were my patient, I'd recommend starting treatment after your first trimester, using a three drug regimen. Many specialists in this field recommend using a AZT-containing regimen (usually as Combivir) with a protease inhibitor (commonly nelfinavir or Kaletra); others will use a non-nuke (nevirapine). HAART can effectively eliminate the risk of transmitting HIV to your baby. Efavirenz (Sustiva) should be avoided because of risk of birth defects. We monitor drug levels in our pregnant patients, as recommended by the Department of Health and Human Services, since it's not uncommon to need to adjust the drug dose because of the increased body size ("volume of distribution") during pregnancy.

I hope this helps. Good luck to you and your child.