Importance of monitoring HIV Viral load during pregnancy

• Viral load requires monitoring for the woman’s own health and to determine the effectiveness of treatment
• The most important factor that predicts the risk of mother to child transmission is the level of HIV virological suppression at delivery, therefore monitoring of VL during pregnancy facilitates decisions about delivery

Monitoring of HIV in pregnancy

• Resistance profile: Before initiation of treatment to ascertain if there are any medications which the woman is resistant to
• CD4 count: A minimum of one CD4 count at baseline and one at delivery 
• Viral load: 2-4 weeks after commencing HAART, at least once every trimester, at 36 weeks and at delivery 
• Liver Function Tests (LFT): at initiation of treatment and at every antenatal visit to monitor for side effects of treatment

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