HIV-infected women can get pregnant

Dia Mundial del Sida

Women with HIV can still get pregnant, the procedure may need special care even though the situation does not entitle extra risks

Medical advances allow that things that seemed impossible a few years ago become natural today. Living a normal life as a carrier of the Human Immunodeficiency Virus (HIV) is one of them, and this improvement in the quality of life of people living with HIV opens the door for many couples to start planning a family. However, when dealing with something so important, doubts always get in the way and fears become even greater.

The first thing we need to make clear is that women with HIV can still get pregnant. However, the procedure may need special care and the woman, even though the situation does not entitle extra risks, needs to make sure the medication or the dose she’s taking is compatible with a pregnancy. In order to avoid other risks or changes in the medication, the mom-to-be must be stable and have her disease under control. The introduction of antiretroviral drugs and the establishment of protocols during pregnancy and childbirth have reduced the risk of infecting the baby, but there is still about 20% chance of infection during pregnancy, labour or breastfeeding.

During the nine months of the pregnancy, the virus can be transmitted through the mother’s blood to the foetus. Sometimes, the virus has even managed to cross the placenta. Anyway, the risk does not disappear once the water breaks, because the infection can also happen during labour. This is why most of the times, when the mother has an unknown or high viral load (more than 1000 copies/ml) doctors try to perform a C-section in order to control the presence of blood.

Once the baby is born, no matter if he is infected or not, he can still have a positive AIDS test result. Therefore, it is highly recommended to talk to the paediatrician and ask for advice on how to proceed to find out whether the baby is infected or not and act accordingly. Even though the baby might not be initially a carrier, in some cases, the HIV can develop later during the first years of his life. This is why, generally, kids that were born from HIV infected mothers are prescribed medication during 4 or 6 weeks after birth. Those drugs against HIV prevent the child from getting any infection caused by the HIV virus that might have been transmitted from the mother to the child during labour. Additionally, it is advised not to breastfeed the baby, since the mother’s milk can also transmit the AIDS virus.

If the male carries the virus, pregnancy is also possible

So far we have raised the possibility that it is the woman who is infected with HIV, but it could also happen that the infection comes from the man. Men can also become fathers with their own sperm, but some extra care will be needed too, in this case prior to proceeding with IVF.

To remove the HIV virus from the sperm, the sample must be first washed, in order to determine the sample viral load through PCR (Polymerase Chain Reaction) techniques later on. If the PCR test is negative, the sperm sample can be used. In these situations, the recommended treatment is an In Vitro Fertilization (IVF), since the process of the sperm sample washing entails a considerable loss of spermatozoids. This makes it impossible that the obtained sample is used for any other assisted reproduction technique. Thanks to this procedure, there is no transmissions risk of the HIV virus to the mother or the fetus.

It seems obvious that there is a higher risk for the baby exposed to the above mentioned situations, but a couple where one of the partners is infected with the HIV virus does not necessarily have to give up their dream of building a family. With some extra care during the whole process, the baby may come to this world without carrying the virus and have a healthy life like any other newborn.