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ARV & pregnancy
Jul 15, 2007

We are supporting a pos woman at HIV Womens service who is on efavirenz & kivexa combination, she is 10 weeks pregnant and Dr suggesting termination as these ARV are contraindictated, during pregnancy .. woman is very distressed...what are you thoughts? thanks Pam Corrdinator HIV Women's projedt South Australia

Response from Dr. Young


Thank you for your post from Australia, sorry about the delay in response.

I wouldn't recommend stopping all antiretroviral medications in the case of pregnancy at all. The real issue is the risk that efavirenz (Sustiva) may play in harming the infant (not the abacavir or 3TC *Kivexa/Epzicom). Keeping the mother's HIV viral load undetectable is the best way to avoid transmission of HIV to the infant.

In this case, I'd probably switch the non-nuke efavirenz for a boosted protease inhibitor, provided that the drug resistance pattern allows. In our center, we'd use lopinavir/ritonavir (Kaletra) in place of efavirenz.

I hope this helps. BY

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