HIV-Infected Women and Their Babies After Birth HIV and Pregnancy

HIV-Infected Women and Their Babies After Birth

I am HIV infected and pregnant. What are the chances my baby will be born with HIV?
In the United States and Europe, less than 2% of babies born to HIV-infected mothers (fewer than 2 babies in 100) are infected with the virus. This is because most HIV-infected mothers and their babies receive anti-HIV medications to prevent mother-to-child transmission of HIV. Chances are if you receive anti-HIV medications during pregnancy and labor and delivery, and if your baby receives anti-HIV medications after birth, your baby will not be infected with HIV.
Terms Used in This Fact Sheet: Mother-to-child transmission of HIV: the passing of HIV from an HIV-infected mother to her infant during pregnancy, during labor and delivery, or by breastfeeding. AZT: an anti-HIV medication in the nucleoside reverse transcriptase inhibitor (NRTI) class. AZT is also called zidovudine, Retrovir, or ZDV. Bactrim: an antibiotic used to prevent and treat infection with Pneumocystis jirovecii pneumonia (PCP). Bactrim is also called Septra, Sulfatrim, Sulfamethoxazole/Trimethoprim, or TMP-SMX. Pneumocystis jiroveci pneumonia (PCP): a lung infection caused by a fungus that occurs in people with weakened immune systems. PCP is considered an AIDS-defining condition in people with HIV. Virologic HIV test: a laboratory test that measures the amount of HIV in a sample of blood. Virologic HIV tests are used to monitor HIV infection and its treatment and to diagnose HIV in infants born to HIV-infected mothers. HIV antibody test: When the body is first exposed to HIV, the immune system produces HIV antibodies to recognize and fight the virus. An HIV antibody test checks for antibodies to HIV. CD4 count: CD4 cells, also called T cells or CD4+ T cells, are white blood cells that fight infection. HIV destroys CD4 cells, making it harder for the body to fight infections. A CD4 count is the number of CD4 cells in a sample of blood. A CD4 count measures how well the immune system is working. Treatment adherence: closely following (adhering to) a prescribed treatment regimen. Adhering to a regimen means taking the correct dose of each medication at the correct time exactly as prescribed. Not adhering to an anti-HIV treatment regimen can prevent antiHIV medications from being effective.

Will my newborn baby receive anti-HIV medications?

Yes. Within 6 to 12 hours after delivery, babies born to HIVinfected mothers receive an anti-HIV medication called AZT. AZT helps prevent mother-to-child transmission of HIV. Babies born to HIV-infected mothers receive AZT for 6 weeks. Sometimes health care providers recommend that other antiHIV medications be given with AZT.

When will my baby be tested for HIV?

HIV testing for babies born to mothers with known HIV infection is recommended at 14 to 21 days, at 1 to 2 months, and again at 4 to 6 months using virologic HIV tests. Virologic tests are different from HIV antibody tests. Instead of detecting antibodies to HIV, virologic tests look directly for HIV in the blood. HIV antibody tests are not used to test babies born to HIVinfected mothers until 12 to 18 months after birth. This is because babies born to HIV-infected mothers carry their mothers antibodies to HIV for up to 18 months after birth. An HIV antibody test would detect the HIV antibodies from the mother and thus not be useful until the baby grows older and the HIV antibodies from the mother disappear. To be diagnosed with HIV, a baby must have two positive virologic tests. One positive virologic test is not enough; a second positive virologic test is necessary to confirm a diagnosis of HIV. To know for certain that a baby is not infected with HIV, the baby must have two negative virologic tests, the first at 1 month, the second at 4 months of age. Many health care providers also order an HIV antibody test at 12 to 18 months to confirm that a baby is not infected with HIV. A negative

HIV antibody test at 12 to 18 months confirms without a doubt that the baby is not infected with HIV. Babies who are infected with HIV receive anti-HIV medications as soon as they are diagnosed. Anti-HIV medications help HIV-infected babies stay healthy. At 6 weeks, HIV-infected babies also start a medication called Bactrim. (Bactrim is also given as a precaution if a babys HIV status is unknown.) Bactrim helps prevent Pneumocystis
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This information is based on the U.S. Department of Health and Human Services Recommendations for Use of Antiretroviral Drugs in Pregnant HIV-1-Infected Women for Maternal Health and Interventions to Reduce Perinatal HIV Transmission in the United States (available at http://aidsinfo.nih.gov/guidelines).

HIV-Infected Women and Their Babies After Birth HIV and Pregnancy

jiroveci pneumonia (PCP), a type of pneumonia that can develop in people with advanced HIV.

What is the best way to feed my baby?

Because HIV can be transmitted through breast milk, you should not breastfeed your baby. In the United States, infant formula is a safe and healthy alternative to breast milk for the babies of HIV-infected mothers. In rare cases, HIV can be transmitted through food that was prechewed by an HIVinfected mother or caretaker. To be safe, babies should not be fed prechewed food.

Will my anti-HIV medications change after I give birth?

You and your health care provider may decide to stop or change your anti-HIV regimen after your baby is born. The decision to continue, change, or stop your anti-HIV medications will depend on several factors: your lowest CD4 count; your health and the stage of your HIV infection; other reasons you take anti-HIV medications, such as for hepatitis B infection; and the preferences of you and your health care provider. Dont stop taking any of your anti-HIV medications without talking to your health care provider first. Stopping your medications may limit the number of anti-HIV medications that will work for you. Having a new baby is exciting! However, it can be stressful to care for a new baby while dealing with the physical and emotional changes that follow childbirth. Taking your antiHIV medications exactly as directed (treatment adherence) may be difficult. If you feel sad or overwhelmed after giving birth or have any concerns about taking your medications, talk to your health care provider. Together, you and your health care provider can make a plan to keep you and your baby healthy.

For more information:

Contact an AIDSinfo Health Information Specialist at 18004480440 or http://aidsinfo.nih.gov. See your health care provider for medical advice.

This information is based on the U.S. Department of Health and Human Services Recommendations for Use of Antiretroviral Drugs in Pregnant HIV-1-Infected Women for Maternal Health and Interventions to Reduce Perinatal HIV Transmission in the United States (available at http://aidsinfo.nih.gov/guidelines).

Page 2 of 2 Updated April 2011