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HIV - Wife and pregnant with HIV + Husband

May 6, 2009

Hi Doctor, Thank you for answeing my question regarding low platelet counts (Platelet count of 6). Like I said, I was diagnoized with HIV+ about 2 weeks back and my wife is tested negative and her viral load is undetectable(after 4 weeks of exposure with me). She is 14.5 weeks pregnant now. Doctor is confident that she will be negative but can only confirm with the test after 5 months from now and if she is tested positive after 5 months..wouldn't it be too late to protect the baby from being infected? Can she be started on medication from now eventhough she is negative, so as to protect the baby? What are the chances that baby will be fine as long as we keep track of her status and viral load every month?

One other thing I need to tell you is, we are married for 6 years and after marriage I never had sex with any other woman. I believe I got infected from unprotected sex that I had before marriage about 7 years ago and my wife never got infected during this 6 years of marriage which is a miracle for us.

Thank you once again and hope you will get a chance to reply to me XYZ

Response from Dr. Frascino


I would not recommend your wife take antiretroviral medications. That she has tested HIV-antibody negative and has an undetectable HIV plasma viral load four weeks after her last potential HIV exposure is extremely encouraging. Should she seroconvert (become HIV-antibody positive) or develop a confirmed significantly elevated HIV viral load, combination antiretroviral therapy should be started at that time. Even five months from now would not be too late to protect the baby from becoming infected. If your wife continues to be followed by an HIV-knowledgeable obstetrician, then the chances your baby will be born HIV negative are excellent.

Assuming you were infected prior to marriage, it is indeed fortunate that your wife did not contract the virus! If you look in the archives, you'll find other stories similar to yours. Once again it's important to note that not every HIV exposure leads to HIV transmission. However, it is indeed possible that transmission could occur even with a single exposure.

Good luck to you both.

Dr. Bob

Platelet count of 6 Apr 25, 2009

Hello Sir, Thank you so much for the service and support you are providing. Last Wednesday I found that I was HIV+ and they did several tests and called me to the emergency next morning as my platelet count was 6. I got 2 platelet transfusions and the count went up to 46 and they discharged me. I was also immediately started on the Therapy due to the platelet count. My CD4 count is 283 and Viral load is 10,000. I have been taking medicines for less than a week now and yesterday I had my blood test for platelets again. This morning they called me back for emergency again as the platelets dropped to 6 again!!!

I got one transfusion today (platelet went to 19) and also got IVIG of 75 grams to cure my ITP disorder. I am very concerned on why my platelets are dropping to so low even after starting HIV medications? Will the platelets raise at all to normal levels with the therapy and how long it takes? There are no other symptoms like bleeding, bruises etc; Have you seen any patients with such low platelets coming back to normal? How else can I improve my platelet count? I know I am askinbg too many questions but I and my wife are so worried about it. Please help!


Response from Dr. Frascino


I'm sorry to hear about your recent HIV diagnosis and thrombocytopenia (low platelets). Low platelets can be caused by a number of underlying conditions, including HIV. An evaluation by an HIV-knowledgeable hematologist may be warranted. There are a variety of potential therapies depending on the presumed cause of low platelets (steroids, intravenous gammaglobulin, antiretrovirals, WinRho, splenectomy, etc.).

Your HIV meds may work or at least help, but it may take longer than a week to see a significant beneficial effect.

Good luck. Close follow-up is warranted with your HIV specialist.

Dr. Bob

Newbie seeks advice. Please answer if you can!
Stocrin and Babies (Safety and Toxicity of Anti-HIV Medications During Pregnancy, 2009)

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