The U.S. Department of Health and Human Services (DHHS) has updated its federal guidelines regarding the use of anti-HIV treatment during pregnancy. The most recent guidelines, published July 6, 2006, have been revised to include updates regarding HIV drug resistance and drug-resistance testing, in order to help guide the selection of treatments that will maximally reduce the risk of mother-to-child HIV transmission.

The guidelines now recommend drug-resistance testing for HIV-positive pregnant women under the following conditions: 1) if anti-HIV treatment is being started or restarted during pregnancy, or 2) if the woman’s viral load does not decrease to undetectable levels or becomes detectable again while on treatment.

The guidelines also counsel against adding single-dose Viramune® (nevirapine) – sometimes given to the mother during labor and the baby immediately after birth – to an ongoing anti-HIV drug regimen, as this does not appear to provide additional benefit in terms of reducing mother-to-child transmission and may result in HIV resistance to Viramune in the mother.

The revised guidelines are available on the AIDS Treatment Information Service website maintained by the DHHS.