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Case 2: Presentation in Labor with No Prior Antiretroviral Therapy

You answered:

B Begin zidovudine (Retrovir) by intravenous infusion, allow the mother to deliver vaginally, and give the newborn oral zidovudine for 6 weeks.

This answer is correct. In this setting, zidovudine by intravenous infusion during labor followed by oral zidovudine given to the newborn for 6 weeks is the standard recommendation in the United States and is supported by epidemiologic data that have shown a significant reduction in HIV transmission when compared with no therapy. In this case, cesarean section delivery would not be advised as a means to reduce HIV transmission because the onset of labor has occurred.

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