Guidelines for the Use of Antiretroviral Therapy in HIV-Infected Pregnant Women
When a woman is able to give birth, that is a gift. But when an HIV-positive woman is able to give birth, and the baby turns out to be negative, that is a miracle of medicine. It is imperative for us women to love and take care of ourselves enough, in order to be able to care for a baby before they are born and after. So, if you are pregnant or thinking about becoming pregnant and you are HIV positive, here are some guidelines recommended by the Department of Health and Human Services (DHHS).
The DHHS is the United States government's principal agency for protecting the health of all Americans and providing essential human services, especially for those who are least able to help themselves.
HIV-infected pregnant women should be offered antiretroviral therapy during their pregnancy. The health care provider should discuss with the expectant mother the known benefits and/or risks to her, and her fetus. When the viral load (HIV-1 RNA) is less than 1,000 copies/ml (milliliters), infected pregnant women should be counseled regarding the potential benefits of standard combination therapy including the three-part ZDV (AZT) chemoprophylaxis regimen (which means prevention of disease by the use of chemicals or drugs). Although some women are at low risk for disease progression if combination therapy is delayed, antiretroviral therapy that successfully reduces HIV-1 RNA levels to below 1,000 copies/ml substantially lowers the risk of perinatal transmission and limits the need to consider elective cesarean delivery as an intervention to reduce transmission risk.
HIV-infected pregnant women generally are given a three-part regimen of AZT, given orally after the first trimester (the first three months of pregnancy):
When women follow this regimen, the transmission risk can be reduced to only .05%. This regimen is recommended for all HIV-positive pregnant women.
We still find it quite interesting that HIV-positive pregnant women are dosed according to their body weight. And contrarily, HIV-positive non-pregnant women are dosed according to studies done in HIV-positive men. It's so nice to know that some things never change.
As of May 4, 2001, the DHHS guidelines recommendations have been updated:
Also the Health Care Financing Administration, which is a federal agency within the DHHS, recommends while you are pregnant:
If you are thinking about becoming pregnant or you are already pregnant, getting proper care and communicating with your doctor will help to ensure that you will have a healthy baby who is not HIV positive.
Sources: The Department of Health and Human Services, the Health Care Financing Administration and WORLD (Women Organized to Respond to Life-Threatening Diseases).
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