Publication Date
2-1-2024
Journal
Current HIV/AIDS Reports
DOI
10.1007/s11904-024-00688-y
PMID
38277098
PMCID
PMC11095844
PubMedCentral® Posted Date
5-15-2024
PubMedCentral® Full Text Version
Author MSS
Published Open-Access
yes
Keywords
Pregnancy, Female, Infant, Newborn, Humans, HIV Infections, Pregnancy Complications, Infectious, Anti-Retroviral Agents, Anti-HIV Agents
Abstract
PURPOSE OF REVIEW: Selection of antiretroviral therapy during pregnancy must consider maternal physiology and resulting pharmacokinetic changes in pregnancy, resistance and efficacy profiles, tolerability and frequency of adverse effects, teratogenicity, and maternal, neonatal, and pregnancy outcomes. The objective of this review is to summarize the underlying data that informs the current clinical perinatal guidelines in the USA.
RECENT FINDINGS: Data now supports the use of dolutegravir at all stages of pregnancy with no significant increase in neural tube defects. Safety and pharmacokinetic data on newer antiretroviral medications in pregnancy continue to lag behind the general population. While there are multiple safety and tolerability concerns with older regimens, there are now multiple options of regimens that are highly efficacious and have good safety data in pregnancy. Most pregnant patients who are virally suppressed on a well-tolerated regimen are able to safely continue those medications during pregnancy.