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Fact Sheet Number 611
PREGNANCY AND HIV
Note: HIV transmission statistics in this fact
load (see Fact Sheet 125) under 1,000, the reduce the future treatment options for the sheet are from a 2005 publication of the
risk is almost zero. Mothers with a high viral United Nations Joint Programme on load might reduce their risk if they deliver their
HIV/AIDS (UNAIDS.)
A pregnant woman should consider all of the Feeding the Newborn
Up to 15% of babies may get HIV infection HOW DO BABIES GET AIDS?
from infected breast milk. Breast feeding is • Pregnant women should not use both ddI The virus that causes AIDS can be transmitted controversial, especially in the developing (Videx, see Fact Sheet 413) and d4T (Zerit, from an infected mother to her newborn child. world. Most transmission from breast feeding see Fact Sheet 414) in their ART due to a high Without antiretroviral treatment, and if mothers occurs within the first two months after birth. rate of a dangerous side effect called lactic breastfeed for 18 to 24 months, up to 35% of However, replacement feeding can increase the risk of infant death. This can be due to loss • Do not use efavirenz (Sustiva) during the of disease protection provided by the mother's Mothers with higher viral loads are more likely milk or the use of contaminated water to mix • If your CD4 count is more than 250, do not to infect their babies. However, no viral load is low enough to be “safe”. Infection can occur any time during pregnancy, but usually A recent study showed that it is possible for a Some doctors suggest that women interrupt happens just before or during delivery. The newborn to become infected by eating food their treatment during the first 3 months of baby is more likely to be infected if the delivery that is chewed for it by an infected mother. takes a long time. During delivery, the newborn • The risk of missing doses due to nausea and vomiting during early pregnancy, giving Drinking breast milk from an infected woman • The risk of birth defects, which is highest can also infect babies. Mothers who are HIV- HOW DO WE KNOW IF A during the first 3 months. There is almost no
infected should generally not breast-feed
NEWBORN IS INFECTED?
evidence of this, except with efavirenz. their babies. To reduce the risk of HIV Most babies born to infected mothers test
• ART might increase the risk of premature infection when the father is HIV-positive, some positive for HIV. Testing positive means you couples have used sperm washing and have HIV antibodies in your blood. Fact Sheet • However, current guidelines do not
support treatment interruption for pregnant
Babies get HIV antibodies from their mother If you have HIV and you are pregnant, or if you HOW CAN WE PREVENT
Another test, similar to the HIV viral load test want to become pregnant, talk with your health INFECTION OF NEWBORNS?
(See Fact Sheet 125, Viral Load Tests), can be care provider about your options for taking used to find out if the baby is infected with HIV. What if the father is infected with HIV?
care of yourself and reducing the risk of HIV Instead of antibodies, these tests detect HIV in Recent studies have shown that it is possible infection or birth defects for your new child. the blood. This is the only reliable way to to "wash" the sperm of an HIV-infected man so determine if a newborn is infected with HIV. that it can be used to fertilize a woman and produce a healthy baby. These procedures are If babies are infected with HIV, their own
THE BOTTOM LINE
immune systems will start to make antibodies. They will continue to test positive. If they are
Use antiretroviral medications: The risk of
pregnant needs to think about her own health not infected, the mother’s antibodies will
and the health of her new child. Pregnancy eventually disappear. The babies will test does not seem to make the mother’s HIV Transmission rates are only 1% to 2% if the mother takes combination antiretroviral therapy (ART.) The rate is also about 2% when the The risk of transmitting HIV to a newborn can mother takes AZT during the last two months be virtually eliminated with “short course” of her pregnancy, the mother takes a single WHAT ABOUT THE MOTHER’S treatments taken only during labor and
dose of nevirapine (See Fact Sheet 431) HEALTH?
delivery. But short treatments increase the risk during labor, and the newborn takes a single Recent studies show that HIV-positive women of resistance to the drugs used. This can dose of nevirapine within 3 days of birth. See who get pregnant do not get any sicker than reduce the success of future treatment for both Fact Sheet 411 for more information on AZT. pregnant is not dangerous to the health of an However, resistance to nevirapine can develop HIV-infected woman. This is true even if the The risk of birth defects caused by ART is in up to 40% of women who take the single mother breast-feeds her newborn for a full dose. This can reduce the success of later term (2 years). In fact, a study in 2007 showed pregnancy. If a mother chooses to stop taking ART for the mother. Resistance to nevirapine that becoming pregnant was good for a some medications during pregnancy, her HIV can also be transmitted to newborns through disease could get worse. Any woman with HIV breast feeding. However, the shorter regimens who is thinking about getting pregnant should are more affordable for developing countries. However, “short-course” treatments to prevent carefully discuss treatment options with her infection of a newborn are not the best choice Keep delivery time short: The risk of for the mother’s health. If a pregnant woman
transmission increases with longer delivery takes ART only during labor and delivery, HIV times. If the mother uses AZT and has a viral might develop resistance to them. This can Revised September 5, 2009
A Project of the New Mexico AIDS Education and Training Center. Partially funded by the National Library of Medicine
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Source: http://www.hoccprograms.org/Pregnancy.pdf