Anti-AIDS Drugs and Pregnancy

A new study has found that women may safely take the anti-AIDS drug nevirapine during pregnancy for the purpose of protecting unborn children from HIV AIDS transmission through the mother. The study, published in the New England Journal of Medicine in January 2007, found that nevirapine will not threaten the health of pregnant women or the effectiveness of life-saving AIDS drug treatment if postponed while using nevirapine.

While nevirapine is associated with certain health risks such as liver poison and rashes, this is only the case in prolonged use. The study has shown that short doses of nevirapine followed by combination drugs six months later is an effective anti-AIDS treatment for both a pregnant woman and her child.

Sexual Health Background: Pregnancy and AIDS

An estimated 120,000-160,000 women in the United States are living with HIV, many of whom are not aware of infection. Approximately 6,000 to 7,000 of women with the AIDS virus give birth each year. Around 90% of children with HIV in the United States had contracted the virus from their mothers either during pregnancy, delivery, or breastfeeding. This is known as perinatal HIV infection. Worldwide, these numbers are much higher, with approximately 600,000 babies contracting HIV AIDS each year.

A government AIDS research conducted in the United States in 1994 showed that drug treatment during pregnancy significantly reduces the likelihood of a baby contracting HIV from an infected mother. Following the study, the Centers for Disease Control and Prevention (CDC) have reported an 83% decline in perinatal HIV infection. In 2002, the CDC recommended that all pregnant women be offered HIV testing as a regular part of prenatal care as a routine AIDS prevention method to avoid HIV transmission from mother to child.

HIV Treatment During Pregnancy: ZDV

It is recommended that AIDS treatment during pregnancy be identical to other AIDS treatment of women who are not pregnant. If a woman in her first trimester has not begun AIDS treatment, it may be possible to postpone treatment until the second trimester, when drug-related risks to the baby are smaller. Otherwise, a woman who has already been taking medication will generally be recommended to continue AIDS treatment throughout the pregnancy.

HIV-infected individuals are typically treated with combinations of HIV-fighting drugs that slow down the spread of the virus in the body, keep the blood levels of the virus low, and help prevent AIDS-related infections.

In 2002, the U.S. Public Health Service released guidelines recommending that infected pregnant women be offered HIV-fighting drugs both to protect AIDS transmission to their child as well as to maintain their own health. The drug zidovudine (ZDV) has been shown to reduce the risk of transmission by two-thirds.

ZDV could be taken in combination with protease inhibitor drugs, or with the drugs 3TC or nevirapine during labor in women without prior treatment. In addition, it is believed that delivery by a caesarian section reduces the risk of AIDS transmission, and newborns should be treated with ZDV for the first six weeks after birth. It is important to let your health care provider know if you are HIV positive, so that specific measures can be taken so as to avoid the exposure of the baby to the mother’s blood during pregnancy and delivery.

Nevirapine During Pregnancy

In wealthy countries, HIV-infected women are usually given two or three antiretroviral drugs in the later stages of pregnancy to prevent AIDS transmission to a child.

The new study conducted by Harvard researchers working in Botswana have found that anti-AIDS cocktail treatments containing nevirapine are still effective if used six months after taking a dose of nevirapine to protect a baby during pregnancy. These findings settle previous fears that nevirapine cocktails encourage drug-resistant strains of the virus.

Health workers working in small clinics around the world have been administering nevirapine to pregnant women, typically providing them with a single pill to be taken when labor begins, and administering single doses of liquid nevirapine in the baby’s mouth after birth.

These studies have shown to decrease the risk of prenatal HIV infection by half when administered under these circumstances. The drug is also commonly found in combination AIDS treatment pills supported by Western donors in poor countries. The drug is a cornerstone of antiretroviral AIDS treatment for poor women in Africa, Asia, and Latin America since the treatment is simple, effective, and inexpensive.

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