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E-mail your questions to aahivm@tpan.com, or send a letter in care of “Ask the HIV Specialist,” TPAN, 5537 N. Broadway St., Chicago, IL 60640.
The American Academy of HIV Medicine (AAHIVM) is an independent organization of physicians, nurse practitioners, physician assistants and others dedicated to advancing excellence in HIV care through the HIV Specialist™ credentialing program, advocacy work and continuing education opportunities.
Positive and Pregnant
I am positive and just discovered that I am pregnant. I am happy to become a mother, but scared because my doctor gave me some very scary information and don’t know if I should reconsider having my child. I have been positive for the past five years. I have had a CD4+ count of over 1,200 for the past three years and have been undetectable for the past three years as well. I was taking Atripla when I became pregnant and my doctor informed me that my child may be born with paralysis from the waist down and this is terrifying, even though she did not know of any statistics on Atripla-related birth defects. Though I stopped the medication I am concerned it is in my system, and I don’t know how long it takes to get out. I would love my child regardless, but if I have to have an abortion, which I don’t want to, and try again after the medication is out of my system, I will. But I just need some information on any HIV treatment-related birth defects that children have had from their mothers taking Atripla. I thank you in advance for your time and consideration. Please don’t post my message, but if it can help other mothers in my situation you may without my name being disclosed.
Name withheld
The concern about taking Atripla in early pregnancy is that it contains efavirenz (also known as Sustiva), which has been associated with some serious birth defects, most related to failure of normal development of the spine and central nervous system. In the worst cases, this can indeed be associated with paralysis or other problems. However, the risk of this type of abnormality may be quite low. In the Antiretroviral Pregnancy Registry, which tracks the safety of antiretroviral drugs in pregnancy, the risk of birth defects with early exposure to efavirenz was no greater than the general risk of birth defects in the overall population (including HIV-negative pregnant women). Several other small studies have been reassuring as well. An ultrasound during the second trimester of pregnancy can usually detect abnormalities of this type.
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Jean R. Anderson, M.D., AAHIVS
Professor, Department of Gynecology and Obstetrics, Director, Division of Gynecologic Specialties, The Johns Hopkins University School of Medicine |
Are you in the care of an AAHIVM-credentialed HIV specialist™?
If you are living with HIV, you want the best possible care from your doctor, nurse practitioner, or physician assistant—to help you effectively and efficiently manage your health and wellness. You want partners in your health care who are knowledgeable about HIV, and who are experienced in treating the person living with HIV. You want HIV treaters who continually seek to raise the standards of HIV care quality and who keep up to date on the latest clinical information on HIV treatment, and who seek measurable assessments of their HIV care delivery knowledge and experience. You want an AAHIVM-credentialed HIV Specialist™!
The American Academy of HIV Medicine (AAHIVM)’s HIV Specialist™ credentialing program is first and only clinical credentialing program offered domestically and internationally to physicians (MDs and DOs), nurse practitioners, and physician assistants specializing in HIV care. HIV care providers become designated HIV Specialists™ after meeting experience and education requirements, and successfully completing a rigorous exam on HIV-specialized medical care.
How do I know if my provider is an HIV Specialist™?
First, look for the letters AAHIVS after your doctor’s, nurse practitioner’s, or physician assistant’s name. AAHIVM-credentialed HIV Specialists™ earn their AAHIVS designation after completing all requirements of the credentialing program, including the credentialing exam.
How Can I Find an HIV Specialist™ in My Area?
AAHIVM’s unique Find A Provider directory located at www.aahivm.org makes the search for an AAHIVM-credentialed physician, nurse practitioner, or physician assistant is as easy as a mouse click. Just click on the Find a Provider window on the home page, key in your location, and click the search button for a list of HIV Specialists closest to you locally or regionally.
The American Academy of HIV Medicine
Advancing Excellence in HIV Care
www.aahivm.org
Due to the space limitations, all submitted questions cannot be answered in this column but we are making every effort to ensure you receive the information you have requested from the HIV Specialist™. For more information about AAHIVM, visit www.aahivm.org or call 202-659-0699.
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