Pneumocystis carinii pneumonia after the discontinuation of long-term antiretroviral therapy in an HIV-1-infected pregnant woman

The management of antiretroviral therapy during the first trimester of pregnancy in HIV-infected women is a debated issue [1,2]. The possible options include continuing the regimen, changing it if it includes drugs involving an increased risk of teratogenic effects, such as efavirenz or delavirdine [3], or discontinuing all antiretroviral drugs until after the first trimester. This last strategy may cause viral rebound and immunological depletion, and increase the risk of mother-to-child HIV transmission [2,4]. We report here a case observed in our outpatient clinic that can be considered in defining the risk of discontinuing antiretroviral therapy in a pregnant woman.