The standard drug regimens that are used for treating opportunistic illnesses in non-pregnant HIV positive women are also generally recommended for the treatment of AIDS-related complications in pregnant HIV positive women, although there are some exceptions where certain drugs should ideally be avoided, especially in the first trimester. Please see specific OI treatment sections for more details
There are no trial data examining the optimum time to start cART in the context of treating opportunistic infections in pregnancy. However, there is a consensus that in most situations cART should be started as soon as possible.There have not been any publications describing immune reconstitution inflammatory syndrome (IRIS) relating to opportunistic infections in pregnancy for patients on cART, but this must at least be a theoretical concern.
Drugs used in the treatment of OIs commonly have important drug-drug interactions with components of cART. This is further complicated by the impact of pregnancy on drug concentrations. Expert pharmacy advice is essential.