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Sustiva in 5th week of pregnancy...
Aug 20, 2005

Dear Dr. Luzuriaga I am an Medical Assistant in Rhode island and my best friend is pregnant and HIV+. She is asking me a lot of stuff about HIV but my knowledge is limited. She is pregnant for 5-6 weeks now her LMP was july 13, 2005. She was taking sustiva & combivir before until Aug. 15, 2005 she stopped taking it as per doctors advice until the 3rd trimester.Then she has to take a HAARt suitable for pregnancy. She is so worried that there will be an effect to the fetus. Did you know somebody who took sustiva during the 1st month of pregnancy that the baby turned out fine and free of defects? What are the chances of her having a normal and healthy baby of the mother who took sutiva for 1st month of pregnancy? By the way her CD4 is 800 and VL is <50. Doctor i am hoping for your reply so I have something to tell my friend the next time she ask me. Thank you and more power to all of you.

Response from Dr. Luzuriaga

Sustiva is not recommended for use during pregnancy (and especially during the first trimester) because of reports of fetal malformations in monkeys or human babies whose mothers received Sustiva during pregnancy. In the monkey study, 3 of 20 fetuses whose mothers were administered Sustiva during pregnancy had malformations. In a human study that documented pregnancy outcomes in women who had received Sustiva during pregnancy, 5 of 128 infants had malformations. So, not all infants exposed to Sustiva will develop malformations but stopping the medication is wise. With an undetectable viral load on therapy, less than 1% of women will transmit the virus to their baby.

CD4 counts and treatment

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