OBSTETRIC- HIV
harry206 - 05-13-09 05:33

A 31-year-old HIV-positive mental health counselor presents to the gynecologist because she suspects that she is pregnant. Her last menses was almost thirteen weeks ago. She was prompted to make today’s appointment because an over-the-counter urine pregnancy test came back positive. She was pregnant once before as a teenager but had an elective abortion. She is not certain how she contracted HIV, but suspects it happened several years ago during a time when she had sexual intercourse with multiple partners and was regularly injecting heroin. After being diagnosed as HIV positive three years ago, she entered drug rehabilitation and has not relapsed. She is able to tolerate the side effects from her three-drug antiretroviral regimen of zidovudine, lamivudine, and saquinavir. At her last visit one month ago, laboratory testing revealed her CD4 count to be 610/µL and HIV load <50 copies/mL. This woman indicates she would like to continue the pregnancy because she recently married "the man of my dreams" and has always wanted to have a child.
The appropriate treatment recommendations are made. Since entering drug rehabilitation, the woman says she has made significant efforts to "clean up my life." She consumes a largely vegetarian diet, exercises regularly, and does not smoke cigarettes or drink alcohol. She indicates she would like to breastfeed her child. Which of the following is the most appropriate recommendation given her circumstances?