Antiretroviral treatment in pregnancy.

Antiretroviral therapy, for pregnant women with HIV infection, is showing itself to benefit both the mother and the fetus, however, certain considerations should be made prior to choosing the agents to be used. Considerations concerning toxicity and safety for the fetus and the mother are discussed, as is the effectiveness of appropriate antiretroviral therapy in reducing perinatal transmission of HIV. General guidelines suggest the following: monitoring CD4 counts and viral loads in pregnant patients the same way as it is done for non-pregnant adults; add AZT to the regimen whenever possible; consider delaying antiretroviral therapy until after 10-12 weeks gestation for pregnant women not currently being treated; and continue antiretroviral therapy if the patient becomes pregnant during therapy. Ultimately, it is the woman's decision whether or not to have antiretroviral treatment during pregnancy. The decision should result from a detailed discussion, with an experienced health care provider, about the risks and benefits of antiretroviral treatment.