ABSTRACT
In resource limited countries, the use of CD4 T lymphocytes count for initiation of antiretroviral prophylaxis, treatment and clinical monitoring is routinely used within a broken health system with limited trained health care personnel, laboratory infrastructure, health insurance, lack of effective government oversight and policies especially in remote rural clinics where most of the pregnant women in resource limited settings live. To address the lack of infrastructure in remote areas, universal initiation is being proposed (Zolfo et al. 2010) which might be possible in small developing countries like Botswana with a population of about 1.6 million, high GDP, and with one of the most effective public health systems for managing HIV infected women. However it would be close to impossible in large resource limited countries such as Nigeria with over 140 million people, a low GDP, poor medical infrastructure, and vast numbers of persons including HIV infected pregnant women requiring AIDS drugs. This chapter addresses possible treatment strategies for HIV
infected pregnant women with low CD4 T lymphocyte count and the challenges that such strategies face in the developing world.
