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effects of ribavirin on HIV pregnant woman on ARV therapy
Mar 15, 2005

An HIV-infected woman on ARV therapy got pregnant from her husband who has HBV and HCV Infection and is on treatment with peg-interferon and ribavirin. She is now 8 weeks pregnant. What is your advice to them?

Response from Dr. Conway

There are 3 issues here. First, the ARVs she is taking. These should be reviewed for their potential to cause congenital anomalies. In genral terms, nevirapine, nelfinavir and all the NRTIs are the safest, but the most important thing is for the mother to receive effective therapy. Second, the peg-interferon is potentially teratogenic, but can be used in pregnancy if the beenfits outweigh the risks. Here, I do not think we should be concerned about it, especially since only the husband took it. The ribavirin is quite teratogenic and also causes abnormalities of the male sperm, which could increase the likelihood that the fetus is malformed. This information needs to be considered as part of the decision to continue with the preganancy or not.

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