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Six weeks pregnant on HAART
Feb 19, 2004

What drugs have been used safely during pregnancy?

I am currently taking Combivir and viramune. My doctor has not had many HIV positive pregnant women in his practice. I think he sees mostly gay men. I am 6 weeks pregnant.

Response from Dr. Luzuriaga

Many licensed antiretroviral therapies have been used safely during pregnancy (See the Guide for the Use of Antiretroviral Agents During Pregnancy under the "Treatment Guidelines" secion of this web site for a nice review). The only licensed antiretroviral that is not recommended for use during pregnancy is efavirenz, due to congenital abnormalities that were observed in offspring of monkeys who received high doses of efavirenz during pregnancy. However, the risk of liver toxicity may be slightly increased in pregnant women on stavudine/didanosine combination or in some women who receive chronic nevirapine therapy. CD4 T cell count > 250 appears to be associated with increased risk of liver problems in pregnant women on nevirapine; underlying liver problems (e.g., due to hepatitis C virus co-infection) also increases the risk of liver toxicity. So, some experts have recommended caution in using nevirapine or stavudine/ddI combinations during pregnancy. However, some women, particularly those with limited treatment options may benefit from the use of these agents and close monitoring of liver function tests, particularly over the first 18 weeks of therapy, is recommended if these agents are used. I would urge you to discuss your situation, including possible treatment options, with your care provider.


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