Welcome to the CCO Site

Thank you for your interest in CCO content. As a guest, please complete the following information fields. These data help ensure our continued delivery of impactful education. 

Become a member (or login)? Member benefits include accreditation certificates, downloadable slides, and decision support tools.

Submit

ART Selection in Women of Childbearing Age and During Pregnancy
  • CME
  • CE

Susan Cu-Uvin, MD
Program Director
Jean Rene Anderson, MD
Released: August 6, 2020
Back Next

References

  1. US Department of Health and Human Services. Guidelines for the use of antiretroviral agents in adults and adolescents with HIV. Available at: https://aidsinfo.nih.gov/guidelines. Accessed July 24, 2020.
  2. Saag MS, Benson CA, Gandhi RT, et al. Antiretroviral drugs for treatment and prevention of HIV infection in adults: 2018 recommendations of the International Antiviral Society-USA Panel. JAMA. 2018;320:379-396.
  3. World Health Organization. Update of recommendations on first- and second-line antiviral regimens. Available at: https://www.who.int/hiv/pub/arv/arv-update-2019-policy/en/. Accessed May 4, 2020.
  4. WHO. Updated recommendations on first-line and second-line antiretroviral regimens and post-exposure prophylaxis and recommendations on early infant diagnosis of HIV. Interim guidance. Available at: https://www.who.int/hiv/pub/guidelines/ARV2018update/en/. Accessed July 24, 2020.
  5. US Department of Health and Human Services. Recommendations for the use of antiretroviral drugs in pregnant women with HIV infection and interventions to reduce perinatal HIV transmission in the United States. Available at: https://clinicalinfo.hiv.gov/guidelines/perinatal/overview-1. Accessed October 8, 2020.
  6. Leticee N, Viard JP, Yamgnane A, et al. Contraceptive failure of etonogestrel implant in patients treated with antiretrovirals including efavirenz. Contraception. 2012;85:425-427.
  7. Perry SH, Swamy P, Preidis GA, et al. Implementing the Jadelle implant for women living with HIV in a resource-limited setting: concerns for drug interactions leading to unintended pregnancies. AIDS. 2014;28:791-793.
  8. Pyra M, Heffron R, Mugo NR, et al. Effectiveness of hormonal contraception in HIV-infected women using antiretroviral therapy. AIDS. 2015;29:2353-2359.
  9. Patel RC, Onono M, Gandhi M, et al. Pregnancy rates in HIV-positive women using contraceptives and efavirenz-based or nevirapine-based antiretroviral therapy in Kenya: a retrospective cohort study. Lancet HIV. 2015;2:e474-e482.
  10. Cohn SE, Park JG, Watts DH, et al. Depo-medroxyprogesterone in women on antiretroviral therapy: effective contraception and lack of clinically significant interactions. Clin Pharmacol Ther. 2007;81:222-227.
  11. Nanda K, Amaral E, Hays M, et al. Pharmacokinetic interactions between depot medroxyprogesterone acetate and combination antiretroviral therapy. Fertil Steril. 2008;90:965-971.
  12. Watts DH, Park JG, Cohn SE, et al. Safety and tolerability of depot medroxyprogesterone acetate among HIV-infected women on antiretroviral therapy: ACTG A5093. Contraception. 2008;77:84-90.
  13. Luque AE, Cohn SE, Park JG, et al. Depot medroxyprogesterone acetate in combination with a twice-daily lopinavir/ritonavir-based regimen in HIV-infected women showed effective contraception and a lack of clinically significant interactions, with good safety and tolerability: results of the ACTG 5283 study. Antimicrob Agents Chemother. 2015;59:2094-2101.
  14. Tepper NK, Curtis KM, Cox S, et al. Update to U.S. medical eligibility criteria for contraceptive use, 2016: updated recommendations for the use of contraception among women at high risk for HIV infection. MMWR Morb Mortal Wkly Rep. 2020;69:405-410.
  15. Mngqibisa R, Kendall MA, Dooley K, et al. Pharmacokinetics and pharmacodynamics of depot medroxyprogesterone acetate (DMPA) in African women receiving treatment for HIV and TB: potential concern for standard dosing frequency. Clin Infect Dis. 2019;[Epub ahead of print].
  16. Momper JD, Best BM, Wang J, et al. Elvitegravir/cobicistat pharmacokinetics in pregnant and postpartum women with HIV. AIDS. 2018;32:2507-2516.
  17. Momper JD, Stek A, Wang J, et al. Pharmacokinetics of atazanavir boosted with cobicistat during pregnancy and postpartum. Program and abstracts of the 20th International Workshop on Clinical Pharmacology of HIV Hepatitis & Other Antiviral Drugs; May 14-16, 2019; Noordwijk, the Netherlands. Abstract 27.
  18. Crauwels HM, Osiyemi O, Zorrilla C, et al. Reduced exposure to darunavir and cobicistat in HIV-1-infected pregnant women receiving a darunavir/cobicistat-based regimen. HIV Med. 2019;20:337-343.
  19. Connor EM, Sperling RS, Gelber R, et al. Reduction of maternal-infant transmission of human immunodeficiency virus type 1 with zidovudine treatment. N Engl J Med. 1994;331:1173-80.
  20. Orrell C, Hagins DP, Belonosova E, et al. Fixed-dose combination dolutegravir, abacavir, and lamivudine versus ritonavir-boosted atazanavir plus tenofovir disoproxil fumarate and emtricitabine in previously untreated women with HIV-1 infection (ARIA): week 48 results from a randomised, open-label, non-inferiority, phase 3b study. Lancet HIV. 2017;4:e536-e546.
  21. Thompson M, Brar I, Brinson C, et al. Tenofovir alafenamide vs tenofovir DF in women: pooled analysis of 7 clinical trials. Program and abstracts of the 2019 Conference on Retroviruses and Opportunistic Infections; March 4-7, 2019; Seattle, Washington. Abstract 519.
  22. Orkin C, Kityo C, Koenig E, et al. Efficacy and safety of bictegravir/emtricitabine/tenofovir alafenamide vs comparators in cis-women and girls (living with HIV): an analysis of 5 clinical trials. Program and abstracts of the 17th European AIDS Conference; November 6-9, 2019; Basel, Switzerland. Abstract PS7/6.
  23. Zash R, Makhema J, Shapiro RL. Neural-tube defects with dolutegravir treatment from the time of conception. N Engl J Med. 2018;379:979-981.
  24. Zash R, Holmes L, Diseko M, et al. Update on neural tube defects with antiretroviral exposure in the Tsepamo study, Botswana. Program and abstracts of the 23rd International AIDS Conference Virtual; July 6-10, 2020. Abstract OAXLB01.
  25. Zash R, Holmes L, Diseko M, et al. Neural-tube defects and antiretroviral treatment regimens in Botswana. N Engl J Med. 2019;381:827-840.
  26. Zash R, Holmes L, Diseko M, et al. Neural tube defects by antiretroviral and HIV exposure in the Tsepamo Study, Botswana. Program and abstracts of the 10th International AIDS Society Conference on HIV Science; July 21-24, 2019; Mexico City, Mexico. Abstract MOAX0105LB.
  27. Werler MM, Shapiro S, Mitchell AA. Periconceptional folic acid exposure and risk of occurrent neural tube defects. JAMA. 1993;269:1257-1261.
  28. Mofenson LM, Vannappagari V, Scheuerle AE, et al. Periconceptional antiretroviral exposure and central nervous system (CNS) and neural tube birth defects: data from Antiretroviral Pregnancy Registry (APR). Program and abstracts of the 10th International AIDS Society Conference on HIV Science; July 21-24, 2019; Mexico City, Mexico. Abstract TUAB0101.
  29. Shamsuddin H, Raudenbush C, Sciba B, et al. Pregnancy outcomes following raltegravir exposure. Programs and abstracts of IDWeek 2019; October 2-6, 2019; Washington, DC. Abstract 886.
  30. Mukherjee S, Velez Edwards DR, et al. Risk of miscarriage among black women and white women in a U.S. prospective cohort study. Am J Epidemiol. 2013;177:1271-1278.
  31. Lawn JE, Blencowe H, Waiswa P, et al. Stillbirths: rates, risk factors, and acceleration towards 2030. Lancet. 2016;387:587-603.
  32. The Antiretroviral Pregnancy Registry Interim Report. Available at: http://www.apregistry.com/forms/interim_report.pdf. Accessed July 24, 2020.
  33. Texas Department of State Health Services. Texas birth defects registry. Available at: https://www.dshs.texas.gov/birthdefects/data/BD_Data_00-09/Report-of-Birth-Defects-Among-2000---2009-Deliveries/. Accessed July 24, 2020.
  34. Canfield MA, Mai CT, Wang Y, et al. The association between race/ethnicity and major birth defects in the United States, 1999-2007. Am J Public Health. 2014;104:e14-e23.
  35. Raesima MM, Forhan S, Thomas V, et al. Addressing the safety signal with dolutegravir use at conception: additional surveillance data from Botswana. Program and abstracts of the 10th International AIDS Society Conference on HIV Science; July 21-24, 2019; Mexico City, Mexico. Abstract MOAX0106LB.
  36. Rasi V, Cortina-Borja M, Peters H, et al. Brief report: surveillance of congenital anomalies after exposure to raltegravir or elvitegravir during pregnancy in the United Kingdom and Ireland, 2008-2018. J Acquir Immune Defic Syndr. 2019;80:264-268.
  37. Sibiude J, Le Chenadec J, Mandelbrot L, et al. No increase in birth defects in infants exposed to integrase inhibitors at conception. Program and abstracts of the 2019 Conference on Retroviruses and Opportunistic Infections; March 4-7, 2019; Seattle, Washington. Abstract 744.
  38. Avagliano L, Massa V, George TM, et al. Overview on neural tube defects: from development to physical characteristics. Birth Defect Res. 2019;111:1455-1467.
  39. Crider KS, Devine O, Hao L, et al. Population red blood cell folate concentrations for prevention of neural tube defects: Bayesian model. BMJ. 2014;349:g4554.
  40. Myer L. ART for prevention in women of childbearing age: Issues to consider. Program and abstracts of the 10th International AIDS Society Conference on HIV Science; July 21-24, 2019; Mexico City, Mexico. Abstract WESY0105.
  41. Dugdale CM, Ciaranello AL, Bekker LG, et al. Risks and benefits of dolutegravir- and efavirenz-based strategies for South African women with HIV of child-bearing potential: a modeling study. Ann Intern Med. 2019;170:614-625.
  42. Phillips AN, Venter F, Havlir D, et al. Risks and benefits of dolutegravir-based antiretroviral drug regimens in sub-Saharan Africa: a modelling study. Lancet HIV. 2019;6:e116-e127.
  43. Kintu K, Malaba T, Nakibuka J, et al. RCT of dolutegravir vs efavirenz-based therapy initiated in late pregnancy: Dolphin-2. Program and abstracts of the 2019 Conference on Retroviruses and Opportunistic Infections; March 4-7, 2019; Seattle, Washington. Abstract 40LB.
  44. Mirochnick M, Shapiro D, Morrison L, et al. Randomized trial of raltegravir-ART vs efavirenz-ART when initiated during pregnancy. Program and abstracts of the 2019 Conference on Retroviruses and Opportunistic Infections; March 4-7, 2019; Seattle, Washington. Abstract 39LB.
Back Next
Provided by Clinical Care Options, LLC

Clinical Care Options, LLC
12001 Sunrise Valley Drive
Suite 300
Reston, VA

Sophia Kelley
(203)-316-2125
skelley@clinicaloptions.com
www.clinicaloptions.com

Educational grant provided by
Merck & Co., Inc.
ViiV Healthcare

Leaving the CCO site

You are now leaving the CCO site. The new destination site may have different terms of use and privacy policy.

Continue