Many people think that if you are infected with HIV, you can’t have children. There are three types of HIV-positive families: male positive and female negative, female positive and male negative, and both positive. Whether the male or female partner is HIV positive, if you want to get pregnant, you should first treat until the HIV viral load is undetectable, and the CD4 test should be as high as possible within the optimal range of immune function, such as above 800 or 1000, to have a safer sex life. In general, among all the indicators, the main thing to look at is the viral load. As for the testing standards for both couples, they are the same.
How often should viral load and CD4 be checked?
In foreign countries, CD4 is a relatively minor indicator, and as long as the viral load is not detected, it does not matter if CD4 is checked only once a year or once every two years; in China, due to the price of testing reagents and free state support, viral load is checked only once a year, while CD4 is checked four times in the first year and twice in the second year after the disease is detected. Both tests are needed to see if the patient can have children.
Is one normal viral load test enough to prepare for pregnancy?
I recommend that patients be checked according to the number of follow-up visits required by the state, so that the cost of testing is less and easier for patients to afford; usually patients who have been on regular antiviral treatment for more than six months and have been tested in a regular laboratory, where the viral load is no longer detectable, can prepare for pregnancy. A normal test is sufficient, and if there is any abnormality, the test can be repeated at an interval of three months.
What should I do if some tests are not normal (e.g., CD4/CD8 index is flipped)?
Although a higher CD4/CD8 ratio is better, there is no need to worry too much about a low CD4/CD8 ratio. In general, the most critical indicator is the viral load. If there is no virus in the body and it is undetectable, CD4 can be restored and the immune function will be restored and various symptoms will disappear; on the contrary, if there is still virus in the body and the immune function is defeated by the virus, only then will various symptoms be shown. Generally speaking, factors such as cold, fever and menstruation may have some influence on the CD4 index, but the viral load test is not interfered by these factors.
What if I get pregnant without meeting the requirement, or if I find out that I am HIV positive only after I get pregnant?
Doctors require that it is best to get pregnant again without a viral load check, but this is not absolute. Many pregnant women are actually found to be HIV-positive only after they become pregnant, or some patients have an unplanned pregnancy. At this time, her viral load is relatively high and her CD4 level can be high or low. In this case, it is also possible to continue the pregnancy, to be evaluated by the doctor, to be treated aggressively, and to have a healthy child.