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CD4 count of 59 and preg
Mar 4, 2004

hi i am 6 months pregnant, and my CD4 count is 59. what are the chances of me infecting the baby? i am currently on combivir alone

Response from Dr. Lee

I would like to object to the wording of your question. If your baby is born with HIV infection, it is not you who infected your baby, but the virus. I say this because mothers tend to carry a tremendous almount of guilt about any problems their babies may have. I wish to be clear that you are not causing your baby to be infected. If you had a real choice, you would choose that your child would be healthy and not have to deal with HIV. But, you do not make that decision.

To be sure, you have some choices. For example, you can choose to take medications to reduce the chance that the virus will be passed to your baby. You can choose to eat a nutritional diet, get plenty of rest, avoid substances of abuse (alcohol, cocaine, etc.), treat any vaginal infections, take prenatal vitamins, etc. But, even if you do all the "right" things, your baby may still be born with HIV.

You say your CD4 count is (59) and while that is fairly low, it may not be directly associated with passing the virus to the baby. More directly connected to transmission to others is the viral load or amount of virus circulating in your system.

>If the combivir has completely suppressed or reduced the amount of virus to very low levels, it is not likely that you will pass the virus to your child. >If you do not have completely controlled virus, you might want to consider adding other medicines and/or delivering by a ceasarian section rather than have the baby pass through your vagina. >If you were on the medicine even before you were pregnant, it is less likely that your baby will be infected.

Also, you ought to be on medicine to help protect you from the infections that you are more likely to get with such a low CD4 level. (Especially pneumonia.) Talk with your doctor very soon about prophylactic medicine.

Best to you and your baby! Be well.


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