Will combivir, efavirenz deform my baby?
Aug 02, 2009
FACE HIV<br><i>WITH DR. WATITI</i><br><br>Dear Doctor, <br>I am aged 23, HIV positive and pregnant. My CD4 count is 400 cells/ml. Recently, I was given Combivir and Efavirenz by my doctor to take to protect my baby. I expect to deliver next month but
FACE HIV
WITH DR. WATITI
Dear Doctor,
I am aged 23, HIV positive and pregnant. My CD4 count is 400 cells/ml. Recently, I was given Combivir and Efavirenz by my doctor to take to protect my baby. I expect to deliver next month but someone says this combination is not good and I may give birth to a deformed baby. I am worried about the safety of my baby. Should I continue taking the drugs?
- Jane
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Dear Jane,
Normally when using ARVs, we avoid giving Efavirenz to pregnant women or those who plan to become pregnant because it affects the development of the foetus, especially in the first three months of pregnancy.
Since your CD4 count is still high, the ARVs were given to you for prevention of mother-to-child transmission of HIV and not necessarily for your benefit.
On the other hand, you could not be given Nevirapine which is the alternative to Efavirenz because it causes liver problems when given to women whose CD4 count is over 250 cells/ml.
So, your doctor could have weighed the risk of Efavirenz hurting your baby and decided it was low since you are in the last trimester (last three months of pregnancy when the foetus is fully formed and only awaits to be born at nine months.
Sometimes we use second line ARVs like Alluvia in such cases, then revert to first line drugs after delivery. But this depends on the availability and risk envisaged. Since you are about to deliver, most likely your baby is safe. Continue with your drugs and plan how you will feed the baby to avoid HIV infection through breastfeeding.
WITH DR. WATITI
Dear Doctor,
I am aged 23, HIV positive and pregnant. My CD4 count is 400 cells/ml. Recently, I was given Combivir and Efavirenz by my doctor to take to protect my baby. I expect to deliver next month but someone says this combination is not good and I may give birth to a deformed baby. I am worried about the safety of my baby. Should I continue taking the drugs?
- Jane
------------------------------
Dear Jane,
Normally when using ARVs, we avoid giving Efavirenz to pregnant women or those who plan to become pregnant because it affects the development of the foetus, especially in the first three months of pregnancy.
Since your CD4 count is still high, the ARVs were given to you for prevention of mother-to-child transmission of HIV and not necessarily for your benefit.
On the other hand, you could not be given Nevirapine which is the alternative to Efavirenz because it causes liver problems when given to women whose CD4 count is over 250 cells/ml.
So, your doctor could have weighed the risk of Efavirenz hurting your baby and decided it was low since you are in the last trimester (last three months of pregnancy when the foetus is fully formed and only awaits to be born at nine months.
Sometimes we use second line ARVs like Alluvia in such cases, then revert to first line drugs after delivery. But this depends on the availability and risk envisaged. Since you are about to deliver, most likely your baby is safe. Continue with your drugs and plan how you will feed the baby to avoid HIV infection through breastfeeding.