520 Medicines for AIDS
ART for pregnant women
All pregnant women with a CD4 count of 350 or less, or who are sick with AIDS,
should start ART to improve their health. ART will also help prevent HIV from spreading
to the baby. Pregnant women can take the same ART as other adults in the chart on
page 519, except they cannot take efavirenz in the first 3 months of pregnancy. Once a
pregnant woman starts an ART combination, 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.
Preventing Mother-to-Child Transmission, or PMTCT (ARV prophylaxis)
Women who are not sick with AIDS, or who have a CD4 count over 350, do not need
ART. But to prevent HIV spreading to her baby, a pregnant woman with HIV needs to
take ART medicines during pregnancy, labor, and breastfeeding. The baby will also need
medicines. This is called ARV prophylaxis (prevention). It is given only for a limited
period of time, not life-long. Medicines are only one part of preventing mother‑to‑child
transmission. Safe birth and careful feeding are also important (see page 293).
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 in Option 2. But she should not take efavirenz in the first 3 months of pregnancy.
If the mother is not taking ART for her own health, she and her baby should take the medicines listed
in either Option 1 or Option 2 to prevent HIV from passing to the baby. Find out what is available
and recommended in your country.
Option 1
FOR THE MOTHER
FOR THE BABY
During pregnancy, starting as soon as possible from
14 weeks of becoming pregnant
• she should take zidovudine, 300 mg, 2 times a day.
Immediately after birth, give the baby:
• nevirapine, 2 mg/kg oral suspension (or 6 mg), in a
single dose.
During labor
If not breastfeeding, the baby should also have:
• she should take zidovudine, 600 mg, in a single dose
when labor starts.
• zidovudine, oral suspension, 4 mg/kg, 2 times a day for
6 weeks, OR
If she did not take zidovudine during pregnancy, or took it
for less than 4 weeks, she should also take:
• nevirapine, oral suspension,
2 mg/kg, once a day for 6 weeks.
• nevirapine, 200 mg, in a single dose when labor starts,
AND
• lamivudine, 150 mg, when labor starts, and every
12 hours until the baby is born.
If breastfeeding, the baby should also have:
• n evirapine, oral suspension, 2 mg/kg, once a day from
birth, until 1 week after all breastfeeding has ended.
If she is breastfeeding, she should take:
• z idovudine, 300 mg, 2 times a day for 7 days, AND
• lamivudine, 150 mg, 2 times a day for 7 days.
Option 2
FOR THE MOTHER
Starting as soon as possible from 14 weeks of becoming
pregnant, she should take one of the ART combinations
on page 519. She will need to take the medicines every
day, until 1 week after all breastfeeding has ended.
FOR THE BABY
Whether or not the baby is breastfeeding, he should be
given:
• nevirapine oral suspension, 2 mg/kg, once a day for
6 weeks, OR
• zidovudine oral suspension, 4 mg/kg, once a day
for 6 weeks.
Where Women Have No Doctor 2012