Infections in pregnancyFree in the app
HIV in pregnancy
Viral load at 36 weeks decides the mode of birth.
Source: BHIVA 2025Mode of birth by viral load (36 wk)
| Below 50 copies/ml | Vaginal birth, including VBAC. |
|---|---|
| 50–399 | Consider planned CS. |
| 400 or more | Planned CS from 38 weeks. |
- Start antiretrovirals as early as possible; dolutegravir-based preferred.
- IV zidovudine in labour or before CS if viral load above 1000, unknown or untreated.
- Baby: post-exposure prophylaxis within 4 hours (zidovudine 2 weeks if low risk; triple therapy if high risk).
- Feeding: formula in the UK; WHO supports exclusive breastfeeding when the mother is on ART with good adherence.
A summary for trained clinicians. Always check the full guideline, the patient in front of you and your hospital's protocol. Spotted an error? Tell us.