HIV pregnancy (weird sentence)

[adagio]

So in the book I am reading, i stumble upon this sentence:

" If the pregnant woman has a high CD4 (350 or higher) and does not need antiretroviral medications for her own health, treatment with combination antiretrovirals should still be given to prevent perinatal transmission ....etc...."

I have put in bold and underlining what i find so weird: this previous sentence implies that if someone ot his CD4 above 350, then it means Anitretros are not needed and can be stopped!!!!!!!! this is wrong accordin to what I know, that even if you are asympto and your CD4 are copacetic, still you take Antretros!!!!!!

Can anyone shed some light on what the author intended?!?!?!?!??!!? Am i missing anything here?!?!?

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[rickygbv]

in pregnancy viral load is very important , it must be <1000 , if not, you can transmit the HIV. it is not just CD4 count that is important for treatment.

 

[adagio]

hmmm that was not the question per se. any ideas?

 

[turkeyjerky]

now, most clinicians are beginning ART as soon as the patient is diagnosed, however this wasn't always the case--that line is a relic from the days when ART wasn't recommended until the patient was symptomatic or w/ a CD4 count < 350

 

[adagio]

are you sure?? because the book recognizes that even if the patient is asympto or cd4 has risen above 350 you still keep the therapy!! but in another paragraph!!

 

[deleted311769]

are you sure?? because the book recognizes that even if the patient is asympto or cd4 has risen above 350 you still keep the therapy!! but in another paragraph!!

It used to be that you did not START therapy until CD4 < 350.

The, just like today, once you start, you do not stop, no matter what your CD4 count is. Your book is saying that patients should not go off of meds, even if they cross that threshold.

 

[adagio]

Hence my original question, refer to the first post my friend.

 

[turkeyjerky]

Hence my original question, refer to the first post my friend.

your question has been answered, good sir. The book is stating that, even back in the day, it was recommended to begin ART in pregnant women, no matter the CD4 count, in order to reduce transmission to the baby.

The book is also saying that you shouldn't take the patient off of ART even if their CD4 count recovers. That point is moot under current practice, however.

 

[adagio]

alright, I was just making sure I didnt miss any point here or there!! cant blame an IMG for worrying about step 2 too much