A 31-Year-Old Woman, Gravida 1 Para 0, at 14 Weeks

A 31-year-old woman, gravida 1 para 0, at 14 weeks gestation comes to the office to establish prenatal care.  She has had some nausea but no vomiting, abdominal pain, or vaginal bleeding.  The patient contracted HIV through intravenous heroin use.  She was diagnosed 3 years ago while hospitalized for drug rehabilitation.  The patient is on triple-combination antiretroviral therapy with no significant side effects.  She has no other chronic medical conditions and has had no previous surgeries.  In addition to her HIV medications, the patient takes a daily prenatal vitamin.  She does not use tobacco or alcohol and has not used illicit drugs since rehabilitation.  Temperature is 36.7 C (98.1 F) , blood pressure is 110/60 mm Hg, and pulse is 65/min.  BMI is 24 kg/m².  Pelvic examination reveals a 14-week-sized nontender uterus with no adnexal masses.  Laboratory results are as follows:
Bedside ultrasound reveals a 14-week intrauterine pregnancy with a normal heart rate.
Which of the following is the most appropriate recommendation for this patient?

A) A scheduled cesarean delivery should be performed at 38 weeks gestation
B) Antiretroviral therapy is indicated only during delivery to decrease the risk of vertical transmission
C) Antiretroviral therapy should be discontinued during pregnancy as the viral load is undetectable
D) To decrease the risk of teratogenicity, triple antiretroviral therapy should be reduced to monotherapy
E) Triple antiretroviral therapy should be continued throughout pregnancy