ART for pregnant woman
Posted: Jun 21, 2008
QUESTION:
I have a HIV infected patient who is 25-year-old and 14 weeks pregnant. her lowest CD4 was 700 and her HIV viral
load was never more than 1,000 copies/mL. Should this
patient be treated with antiretroviral drugs and, if so, should the regimen consist of 2 or 3 agents?
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RESPONSE FROM: 
Absolutely. I would definitely treat this pregnant patient.
In the US, we'd use a three-drug regimen with the goal of attaining an undetectable HIV viral load prior to delivery. HIV drug resistance testing prior to starting treatment is highly recommended, especially in pregnancy. Typically, as long as there is no resistance, we'll use an AZT-based treatment (ie, Combivir) with Kaletra. Know that it's also recommended to evaluate lopinavir levels during the third trimester, as the volume of distribution increases (and drug levels decrease).
Best of luck,
BY
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