I am three months pregnant and discovered that I am HIV-positive when I went for a routine HIV test during antenatal care. I do not know whether I should start taking ARVs right away because I have not shown any signs of sickness.
However, my doctor says I should go for a CD4 count and be started on ARVs. What is a CD4 count? Can I live with HIV for 20 years and see my child grow?
What you are going through is a normal reaction to such news as finding out you are HIV-positive. That is why in HIV/AIDS care, we encourage pre and post-test counselling whenever one goes for an HIV test.
Most of the questions you are raising could have been answered if an HIV competent counsellor had attended to you.
What you need now is support counselling to help you go through this turbulent time in your life. The advice you got from hospital is good because since you are pregnant and HIV-positive, you should be started on ARVs as soon as possible.
This should be done regardless of your CD4 count because now we know that most HIV-positive women, who are on ARVs with good adherence, do not easily transmit HIV to their babies.
However, if possible, a CD4 count plus other tests like the kidney and liver function tests plus checking the amount of blood you have should be done before starting to take ARVs. CD4 cells are white blood cells, which help us fight diseases.
HIV destroys them and when they are low, one suffers from opportunistic infections characteristic of AIDS. So, by measuring the CD4 cells, we are able to know how much damage HIV has done to the immune system.
The World Health Organisation recommends all HIV-positive pregnant women regardless of their CD4 count and infants infected with HIV, plus all others whose CD4 count is 500 cells/ml and below to be put on ARVs.
Concerning your baby, it should be put on ARVs (Nevirapine) and Septrin prophylaxis soon after birth.
The baby should be tested for HIV, preferably during the first two months after birth. All children born to HIV-positive mothers are exposed to HIV, but not all are infected during pregnancy, labour or breastfeeding; especially if the mothers are taking ARVs.
The baby should also be exclusively breastfed during the first six months after which other feeds can be introduced. Lastly, concerning how long you are going to live with HIV, no one except God knows.
However, I can tell you that with the advent of ARVs, HIV, if handled well, is no longer an immediate death sentence.
We can now help people living with HIV not to die of AIDS-related causes if they are put on ARVs early and they take them with good adherence.