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Review
. 2024 Feb;21(1):1-10.
doi: 10.1007/s11904-024-00688-y. Epub 2024 Jan 26.

Antiretroviral Therapy in Pregnancy: A 2023 Review of the Literature

Alison N Goulding  1 , Kasey Meeks  2 , Lena Shay  1 , Sarah Casey  3 , Colton Applegarth  4 , Jennifer McKinney  5
Affiliations
Review

Antiretroviral Therapy in Pregnancy: A 2023 Review of the Literature

Alison N Goulding et al. Curr HIV/AIDS Rep. 2024 Feb.

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.

Keywords: Antiretroviral therapy; Pregnancy; Teratogenicity.

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Conflict of interest statement

Declarations

Competing Interests The authors declare no competing interests.

Conflict of Interest The authors declare no competing interests.

References

    1. Division of HIV Prevention, Viral Hepatitis, STD, and TB Prevention. HIV and women [Internet]. Atlanta (GA): Centers for Disease Control and Prevention; [reviewed 2023 Feb 16]. Available from: https://www.cdc.gov/hiv/group/gender/women/index.html.
    1. UNAIDS. Global HIV & AIDS statistics — Fact sheet: UNAIDS; 2024. [updated 2024. https://www.unaids.org/en/resources/fact-sheet.
    1. Nesheim SR, FitzHarris LF, Lampe MA, Gray KM. Reconsidering the number of women with HIV infection who give birth annually in the United States. Public Health Rep. 2018;133(6):637–43. - PMC - PubMed
    1. Panel on treatment of HIV during pregnancy and prevention of perinatal transmission, recommendations for the use of antiretroviral drugs during pregnancy and interventions to reduce perinatal HIV transmission in the United States [Internet]. Department of Health and Human Services. Available at https://clinicalinfo.hiv.gov/en/guidelines/perinatal. Accessed 2023 Oct 15.
    1. Cihlar T, Ray AS. Nucleoside and nucleotide HIV reverse transcriptase inhibitors: 25 years after zidovudine. Antiviral Res. 2010;85(1):39–58. - PubMed