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HIV and Pregnancy – Safety of Anti-HIV Medications During Pregnancy

Women infected with HIV can safely use many anti-HIV medications during pregnancy to protect their health and to prevent transmitting HIV to their babies. However, some anti-HIV medications can cause problems when used during pregnancy. Knowing more about the safety of anti-HIV medications and pregnancy will help you and your health care provider decide what medications are right for you.

It’s not known if babies will have any long-term eects from the anti-HIV medications their mothers use during preg- nancy. However, the risk of mother-to-child transmission of HIV is known. And the illness that results when HIV in- fection is passed from a mother to her child is very real. Be- cause anti-HIV medications can greatly reduce the risk of passing HIV infection from a mother to her child during pregnancy, all pregnant women infected with HIV should take anti-HIV medications.

Information on the use of anti-HIV medications during preg- nancy is limited. But enough information is known to make recommendations about the safety of the most commonly used medications from the three most commonly used classes of anti-HIV medications—protease inhibitors (PIs), non-nu- cleoside reverse transcriptase inhibitors (NNRTIs), and nu- cleoside reverse transcriptase inhibitors (NRTIs). (Not enough information is known to make recommendations about use during pregnancy of entry inhibitors and integrase inhibitors, two additional classes of anti-HIV medications.)

  • ere may be a link between the use of some PIs and high

blood sugar (hyperglycemia) or diabetes. For some women, the risk of hyperglycemia increases in pregnancy. It is unclear if taking PIs adds to this risk. Talk to your health care provider about the use of PIs during pregnancy and about when to have blood tests to check for hyperglycemia or diabetes.

Two NNRTIs, Sustiva and Viramune, should be used in pregnant women only under certain conditions.

  • Sustiva may cause birth defects that develop during the

the passing of HIV from a woman infected with HIV to her baby during preg- nancy, during labor and delivery, or by breastfeeding.

a class of anti-HIV medications. PIs block HIV protease, an enzyme HIV needs to make copies of itself.

a class of anti-HIV medications. NNRTIs bind to and alter re- verse transcriptase, an enzyme HIV needs to make copies of itself.

a class of anti-HIV medications. NRTIs block reverse transcriptase, an enzyme HIV needs to make copies of itself.

a class of anti-HIV medications. Entry in- hibitors block CCR5 , a protein on the CD4 cells that HIV needs to enter the cells.

a class of anti-HIV medications. Inte- grase inhibitors work by blocking HIV integrase, a protein HIV needs to make copies of itself.

too much glucose (sugar) in the blood.

high levels of glucose (sugar) in the blood.

an anti-HIV medication in the NNRTI class. Sustiva is also called efavirenz or EFV.

an anti-HIV medication in the NNRTI class. Vira- mune is also called nevirapine or NVP.

a combination of three anti-HIV medications in one pill—Sustiva (also called efavirenz or EFV), Emtriva (also called emtricitabine or FTC), and Viread (also called teno- fovir or TDF).

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 your immune system is working.

a condition caused by too much lactic acid in the blood.

an anti-HIV medication in the NRTI class. Zerit is also called stavudine or d4T.

an anti-HIV medication in the NRTI class. Videx is also called didanosine or ddI.

  • rst few months of pregnancy. erefore, if possible, use of

Sustiva should be avoided in the rst trimester of preg- nancy. Atripla, a combination pill that contains Sustiva,

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