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Babies born to HIV–infected mothers may become infected before or during birth or through breastfeeding. Therefore, the U.S. Centers for Disease Control and Prevention (CDC) recommends that all pregnant women get tested for HIV. Antiretroviral therapy can significantly reduce the likelihood of an HIV–infected pregnant mother passing the virus to her baby. Patients who were taking antiretroviral medication before becoming pregnant should talk to their healthcare providers to determine the safest and most effective treatment option. In general, efavirenz (Sustiva ®), stavudine (Zerit ®), hydroxyurea (Droxia ® or Hydrea ®), and the oral liquid formulation of amprenavir (Agenerase ®) should not be taken during pregnancy because they may cause harm to the fetus. HIV infection rates shortly before or after birth have been shown to drop to as low as one to two percent for babies if their mothers take combination antiretroviral therapy during pregnancy, as well as zidovudine or nevirapine (Viramune ®) preventative therapy during labor and after birth. The baby is more likely to become infected if the vaginal delivery takes a long time because the newborn is exposed to the mother's blood and vaginal secretions. Mothers with high levels of the virus in their blood might reduce their risk if they deliver their baby by cesarean section (surgical delivery of an infant), also called C–section. While a C–section can reduce the risk of transmission during birth, it is not typically necessary in patients who undergo antiretroviral therapy. HIV–infected mothers should not breastfeed their babies because the virus may be transmitted via the breast milk. Instead, baby formulas should be used.
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