What is HIV?
HIV stands for Human Immunodeficiency (say: IM-you-no-de-FISH-en-see) Virus. HIV is a virus that infects certain cells of
the immune system. It makes the immune system weaker over time. This puts a person at risk for other serious infections.
A woman who is infected with HIV (HIV-positive) can pass the infection to her baby. HIV can be passed to the baby during pregnancy,
at birth, or through breastfeeding. Some women do not know they have HIV until they are pregnant and get tested.
If you are HIV-positive and you are pregnant or plan to have a baby, this page explains how to lower the risk that your baby
will get HIV.
Your baby is less likely to get HIV if you have good care before, during, and after birth
If you are HIV-positive, you should be seeing an HIV specialist. This is especially important if you are pregnant or planning
to have a baby. Your HIV specialist will do the following:
You should also see an obstetrician during your pregnancy. An obstetrician is a medical doctor who has received special training
in the care of women during pregnancy, labour and delivery, and the first few weeks after childbirth.
Your family doctor or the clinic where you were diagnosed can refer you to an HIV specialist and an obstetrician.
Medicine for HIV
There is no cure for HIV, but there are many medicines that can help keep you healthy. Medicine helps to keep your viral load
under control. Keeping your viral load low also helps protect your baby from getting infected with HIV.
What to do if you were taking HIV medicine before getting pregnant
Keeping you healthy is very important for your baby’s health, but some medicines are not safe in pregnancy. If you are already
taking HIV medicine and you want to get pregnant or find out you are pregnant, let your HIV specialist know. He or she can
help recommend the best medicines for you.
Medicine lowers the risk that your baby will get HIV
Taking HIV medicine during pregnancy lowers the risk that you will pass the virus to your baby. Studies have shown that if
a woman takes medicines while she is pregnant and her viral load is low by the time of delivery, the risk of passing HIV to
the baby becomes very low. Your HIV specialist and obstetrician will keep track of your viral load during pregnancy. This
will ensure that your medicines are working and that your baby will not be infected.
| HIV: Medication and Viral Load |
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| Taking HIV medication helps reduce the number of HIV in the blood. The number of viruses in the blood is called "viral load".
When viral load is low, the risk of passing HIV to your baby is greatly reduced.
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When and how long you take HIV medicine depends on your situation
Your HIV specialist will discuss the timing of your HIV medicine with you.
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If you need to take medicine for your own health, you will keep taking medicine after your baby is born.
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Other women may not yet need medicine at their stage of HIV infection. If you do not need HIV medicine for your own health,
you should start taking medicine after the third month of pregnancy. Take it only until your baby is born. Talk to your HIV
specialist about when to stop taking the medicine.
Several HIV medicines are safe in pregnancy
Certain HIV medicines are safest in pregnancy. They include medicines such as zidovudine (AZT), lamivudine (3TC), and lovinapir/ritonavir
(Kaletra). Other medicines have been used in the past and newer medicines are being used more often. Some medicines are definitely
not safe in pregnancy. Your HIV specialist can help recommend the safest and best drugs for you.
Normal delivery vs. caesarean section (C-section)
If your viral load is greater than 1000 when you give birth, a C-section will reduce the risk of passing HIV to your baby.
A high viral load can happen for any of these reasons:
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if the medicines do not suppress the virus completely
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if you started taking medicine late in the pregnancy
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if you are not taking the medicine regularly
If your viral load is less than 1000, a C-section does not make your baby any safer. A C-section is also less safe for you
than a normal (vaginal) delivery. For this reason, if your viral load is low when you go into labour, you should be able to
have a normal delivery.
Talk to your HIV specialist and your obstetrician about what kind of delivery is best for you.
What to do when you go into labour
Keep taking your medicines, even when you start to go into labour. Go to the hospital soon after you suspect you are in labour.
An intravenous (IV) form of one of the medicines you are taking (AZT) should be given to you. IV means medicine that is given
into the vein. It is best to receive it at least 2 to 4 hours before the baby comes.
What to expect when your baby is born
When your baby is born, the baby will be started on AZT within the first 24 hours of life. You will need to give your baby
this medicine 4 times per day for the first 6 weeks of life. This can further reduce the risk of HIV infection in your baby.
Your baby will also need a blood test for HIV.
Do not breastfeed your baby. Breastfeeding is one way of passing HIV from mother to child. Formula is the safest food for
your baby.
For more information, please read "HIV and Your Baby."
For more information
If you have any questions or concerns, contact your physician or the HIV clinic. For more information, please see the following:
Motherisk
www.motherisk.org
CATIE: Community AIDS Treatment Information Exchange
www.catie.ca
Key points
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Pregnant women who are infected with HIV should take medicines to lower the risk of passing HIV to their baby.
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If you take medicines and your viral load is low by the time of delivery, the risk of passing HIV to your baby becomes very
low.
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If your viral load is greater than 1000 at the time of delivery, a C-section reduces the risk of passing HIV to your baby.
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If your viral load is less than 1000, then a C-section does not give any extra benefit to your baby. You should be able to
have a normal (vaginal) delivery.
