ART is a highly recommended therapy for pregnant women with HIV, which is a sexually transmitted disease that can cross the placental barrier and reach the developing fetus. Gone are the days when a woman infected with HIV gave birth to a baby with HIV and lost the baby in a few days or months as the baby succumbed to the infection. With ART, infected women can go on to have healthy babies and prevent the transfer of infection to the next generation.
ART stands for Antiretroviral Therapy. This therapy aims to help pregnant women with HIV. It is a combination of medications that aims to help anyone and everyone with HIV. It acts by suppressing the HIV infection and replication in the body, thereby preventing it from progressing into AIDS. It helps restore the immune system and also prevents the transmission of the infection.
The severity of HIV is usually calculated based on the CD4 cell count in the infected person. They are also categorised into stages. Usually, the treatments are recommended for those in stages 3 and 4. However, for pregnant women, it is recommended to start the therapy irrespective of their stage or CD4 cell count, so as to have the best possible outcomes for both the pregnancy and the baby.
ART helps reduce the chances of transmitting the infection to the baby by decreasing the virus in the blood and genital secretions in the mother. When this ART reaches full suppression, the risk of transmitting the infection to the baby is zero. The baby is also treated for a few weeks after birth, to ensure there is no infection.
For women where HIV is confirmed only after conception, it is advisable to start the ART as soon as possible, irrespective of the gestational age. The treatment should continue throughout the pregnancy, and childbirth and even extend until breastfeeding is complete. This will ensure the virus does not affect the baby in any way.
Starting the Antiretroviral Therapy for pregnant women with HIV can have the following advantages:
According to some studies, the impact of fetal exposure to HIV and ART during pregnancy can vary depending on the gender –
Other possible side effects on the baby are:
ART during pregnancy can have the following side effects on the mother. These side effects are very similar to general pregnancy side effects.
Despite some side effects, which can be adverse in some cases, ART during pregnancy has more benefits to offer. Not treating HIV in the mother can not only affect the mother in the long term but can severely impact the outcome of the pregnancy itself. If HIV progresses into AIDS and affects the baby as well, there is very little that can be done after.
In case of concerns and fears regarding the outcome of the treatment, it is advisable to consult a doctor and understand both the benefits and side effects thoroughly.
For babies born to mothers infected with HIV, WHO recommends ART until the infant turns 6 weeks of age. The treatment should start soon after birth, and continue until the baby completes 4-6 weeks. There are two different medications, one of which can be given once a day and the other can be given twice a day. The doctor in charge will decide on the medication, the dosage and the duration.
It is recommended to take the HIV test at the beginning of pregnancy irrespective of past test results, number of sexual partners or other medical history. ART is a much-needed treatment during pregnancy for those infected with HIV. For pregnant women, it drastically reduces the risk of transmitting the infection to the fetus. With timely ART in pregnancy, both mother and baby can enjoy long healthy lives.
