Dear Madam, I am 25 years old woman from India. I got married a year back. I was a virgin before getting married. I am pregnant now.My last menses date was December 16, 2005.

During my pre natal check up the hospital people did HIV Test and I tested positive. After that my husband also tested positive. The doctor presribed me ZIDOVUDINE tablets. Are these tablets safe and without any side effects. My Delivery will be a month later is it advisable using this powerful tablet. My cd4 count is above thousand. I am not taking any HIV medicines. The doctor who is doing prenatal check up and going to do C-section delivery for me, said I need not take the Zidovudine tablets after delivery. Please answer my questions as early as possible.

The WHO has recently published guidelines for antiretroviral tehrapy for treatment of pregnant women and prevntion of mother-to-child HIV transmission (http://www.who.int/reproductive-health/stis/mtct/index.htm). These guidelines discuss the rationale for antiretroviral therapy and explain the different factors that are considered in recommending antiretroviral tehrapy regimens. If you were not pregnant, have not had any symtoms of HIV, and your CD4 count is over 1000, therapy would not be recommended. However, antiretroviral therapy is recommended for all pregnant women to prevent mother-to-child HIV transmission. Triple combination therapy, (usually with zidovudine (ZDV), 3TC, and a protease inhibitor, offers the best chance for suppressing viral replication in women, minimizing the risk of development of antiretroviral resistance, and minimizing the risk of HIV transmission. You mention the possibility of a C-section. C-sections can reduce the risk of mother-to-child transmission but may not be necessary in women with low (< 1000 copies/ml plasma) or undetectable viral load on triple therapy. However, ZDV alone, begun at 28 weeks is also highly effective in preventing mother-to-child transmission. Nevirapine administered as a single dose to mother at delivery and then a single dose to the baby at 48 hours is also effective, but many experts recommend the concurrent administration of ZDV or ZDV/3TC to minimize the risk of resistance. There is extensive experience with the use of ZDV, 3TC, nevirapine, and many protease inhibitors to prevent mother-to-child HIV transmission and their safety profile is excellent. Again, I would urge you to look over the treatment guidelines and discuss your options with your care provider.