New Guidelines Issued on HIV Treatment During Pregnancy — Physician’s First Watch

Medical News |
September 12, 2017

New Guidelines Issued on HIV Treatment During Pregnancy

By Kelly Young

Edited by David G. Fairchild, MD, MPH, and Jaye Elizabeth Hefner, MD

Tenofovir-emtricitabine should not be a first treatment choice for women with HIV who are pregnant, according to new patient-centered guidelines from The BMJ Rapid Recommendations panel. This contrasts with many current HIV treatment guidelines.

In a weak recommendation, the group says a regimen that includes zidovudine and lamivudine is preferred over one including tenofovir or emtricitabine because the latter "probably" increase risk for early infant death and preterm delivery.

In a strong recommendation, they advise using alternatives to regimens containing tenofovir, emtricitabine, and lopinavir/ritonavir. Adding lopinavir/ritonavir is associated with even greater neonatal risks.

Certain women might opt for tenofovir and emtricitabine, including those who are coinfected with hepatitis B and have a high risk for passing the virus to the infant, or those who have severe anemia, drug allergy or intolerance, or infections resistant to zidovudine or lamivudine.

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