398 Where There Is No Doctor 2011 Green Pages
ART for pregnant women with HIV
All pregnant women with a CD4 count of 350
or less, or who are sick with AIDS, should start
ART to improve their health. The mother’s ART will
also help prevent HIV from spreading to her baby.
Pregnant women can take the same ART as other
adults, except they cannot take EFV (efavirenz) in
the first 3 months of pregnancy. Once a pregnant
woman starts ART, she should continue for the rest
of her life.
A woman who is already on ART when she
becomes pregnant should continue taking it
throughout her pregnancy, during the birth, while
breastfeeding, and after. If the mother is already on
ART, her baby will still need to be treated at birth.
Preventing HIV in babies
ART medicines can be given to a pregnant
woman with HIV and then to the baby after birth,
even if the woman does not yet need ART for her
own health. These medicines can prevent HIV
from spreading to the baby during pregnancy and
breastfeeding. They are given for a limited period of
time, not life-long like ART. Giving medicines in this
way is sometimes called prevention of mother-to-
child (or parent-to-child) transmission (PMTCT or
PPTCT). Medicines are only one part of preventing
HIV in a baby. Safer sex during pregnancy, safe
birth practices, careful feeding of the baby, and
treatment of illnesses in both mother and child are
also important. See Where Women Have No Doctor
for more information.
ART medicines to prevent HIV in babies (mother-to-child transmission)
If the mother is already taking ART, she should continue taking her medicines and also give the
baby the medicines listed below.
If the mother is not taking ART, she and her baby should take the medicines listed below.
FOR THE MOTHER
During pregnancy, starting as soon as
possible from 14 weeks of becoming
pregnant
• she should take AZT (ZDV,
zidovudine), 300 mg., 2 times a day.
FOR THE BABY
Immediately after birth, the baby should
be given:
• NVP (nevirapine), 2 mg./kg. oral
suspension (or 6 mg.), in a single
dose.
During labor
• she should take AZT (ZDV,
zidovudine), 600 mg., in a single dose
when labor starts.
If she has not taken zidovudine at all during
pregnancy, or taken it for less than 4 weeks,
she should also take:
• NVP (nevirapine), 200 mg., in a single
dose when labor starts, AND
• 3TC (lamivudine), 150 mg., when labor
starts, and every 12 hours until the
baby is born.
If she is breastfeeding her baby, she should
continue taking:
• AZT (ZDV, zidovudine), 300 mg.,
2 times a day for 7 days, AND
• 3TC (lamivudine), 150 mg., 2 times a
day for 7 days.
If not breastfeeding, the baby should
also have:
• AZT (ZDV, zidovudine), oral
suspension, 4 mg./kg., 2 times a day
for 6 weeks, OR
• NVP (nevirapine), oral suspension,
2 mg./kg., once a day for 6 weeks.
If breastfeeding, the baby should also have:
• NVP (nevirapine), oral suspension,
2 mg./kg., once a day from birth, until
one week after all breastfeeding has
ended, unless the mother herself is on
ART for her own health. If the mother
is on ART, give the baby NVP for
6 weeks.