I am a 28 year old HIV positive mom married for 3 years to a HIV negative man. I have been positive for 4 years. I found when I was pregnant with my first daughter. I was on viracept, epivir and zerit during the pregnancy. My daughter was born HIV negative but I still had her on AZT for 6 weeks and now she 4 years old and still healthy and negative. My second daughter was born 13 months later. I was on the same meds and she's now 3 years old and negative. I am pregnant again with my third and my HIV specialist Dr put me on nevirapine and truvada. My viral load is undetectable and T-cells are 550. What is the rate of transmission to the baby with my history and my current meds? My second question is should I have C-section? My current OB is forcing it on me. By the way I delivered both my girls vaginally. I was in labor for not more than 5 hours both times. Please help. this is my last baby I just want her to be healthy and negative.I am 20 weeeks pregnant. I've never missed my meds and never miss Dr appointments.

With an undetectable viral load, the risk of transmitting the virus to your baby is under 1%. Is your provider recommending a Cesarian to prevent HIV transmission? Cesarian sections are not generally recommended for women with viral loads under 1000, so please discuss this with him or her.

Nevirapine is a great drug for controlling viral load and for preventing motehr-to-child transmission. However, due to possible liver toxicity, nevirapine is not generally recommended for chronic use in women with Cd4 counts over 250. If you and your provider decide that nevirapine is the best ART for you, your liver function tests should be monitored. You might wish to check out the recently updated "Guidelines for the Use of Antiretroviral Agents During Pregnancy", available on this web site, under the "Treatment Guidelines" section. Good luck!