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What is my best option for HIV med during pregnancy???
Aug 12, 2007

I am planning to try for a second child in August. During my first pregnancy (2002) i was put on Combivir/Nevirapine (CD4 327, VL 120,000). I tolerated the treatment well apart from pre-eclampsia towards the final weeks. After birth stopped medication.

I am back on meds Truvada/Stocrin. I know i'm to drop the Stocrin and my doc had opted for Viracept (which has been recalled). Can i safely go back to Nevirapine with the Truvada (despite my hight CD4)without any complications since i had used it before or what should i use with my Truvada? My current CD4 is 420, VL undetectable.I am planning on switching to Atripla after delivery.

I am running out of time here and don't know what my options are for a safe pregnancy.

Response from Dr. Pierone

Hello, and thanks for posting.

Although there is an increased risk of liver toxicity associated with Viramune for women with CD4+ lymphocyte count above 250 your situation is different because you have tolerated it in the past. This does not guarantee that it will not cause problems, but the risk would be low. But if you and your doctor decide to go with a PI-based regimen then Reyataz or Kaletra could be used along with Truvada. Best of luck!



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