HIV, Pregnancy and AZT

Perinatal means the time right before, and right after, birth. HIV stands for human immunodeficiency virus. HIV is the virus that causes AIDS (acquired immunodeficiency syndrome). The words "perinatal HIV" mean that HIV has been passed to the new baby from the mother. In general, babies born to mothers who have HIV have a 25% to 30% chance of being infected with HIV.

You should talk about this with your doctor. In some states, your doctor is required by law to offer you an HIV test. If you think you are at risk for HIV or may already have the virus, you may want to be tested. If you find out that you are infected with HIV, you might choose not to have children. If you are already pregnant when you find out, you have time to think about doing things to lower the chance that your baby will be infected with HIV.

If you have HIV, your baby can get HIV several ways: during pregnancy, during labor and delivery, or during breast feeding. Most babies get infected with HIV during labor and delivery. There may be less of a chance of passing HIV to your baby if you have a cesarean delivery (a C-section). Talk about this with your doctor.

During pregnancy, the mother's antibodies (part of the immune system that fights germs) are passed on to her baby. So all babies of women with HIV will test positive for HIV antibodies at first. This doesn't mean the baby is infected, though. Babies keep the mother's antibodies until they can make their own, which happens between 6 and 18 months of age.

If the baby isn't infected, he or she will lose the mother's antibodies and start to test negative for HIV sometime between 6 and 18 months of age.

If the baby is infected with HIV, he or she will still lose the mother's antibodies, but the baby will start to make antibodies to HIV. The baby will test positive and continue to test positive for HIV.

Other blood tests, called PCR and viral culture, can also be used to check babies for HIV infection. These tests may be able to tell your doctor if your baby is infected during the first 6 months of age. These tests aren't available at all clinics, however, so ask your doctor if they are available.

Not necessarily. You should talk about it with your doctor. There are medicines that can lower the chance that you will pass the HIV virus to your baby.

Medicine can't totally protect your baby from getting HIV, but it can lower the chance that the baby will get the virus. A medicine called zidovudine (brand name: Retrovir) can reduce the chance of passing HIV from mother to baby by two-thirds. Zidovudine slows the growth of the virus, so the baby's immune system (which helps fight germs and illness) can get stronger. The medicine is also called AZT.

It is not thought that AZT causes birth defects in babies whose mothers took the drug during pregnancy. However, no one can tell for sure how AZT will affect your baby as he or she grows up. The medicine hasn't been used in pregnant women long enough to know what will happen to their children when they get older. Talk about the risks and benefits of AZT with your doctor.

Because HIV can be passed to the baby through breast milk, it's better to bottle feed your baby if you are infected with HIV.