A Multicenter Analysis of Elvitegravir Use During Pregnancy on HIV Viral Suppression and Perinatal Outcomes.

Autor: Badell ML; Division of Maternal-Fetal Medicine, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia., Sheth AN; Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia., Momplaisir F; Division of Infectious Diseases and HIV Medicine, Drexel University School of Medicine, Philadelphia, Pennsylvania., Rahangdale L; Department of Obstetrics & Gynecology, University of North Carolina, Chapel Hill, North Carolina., Potter J; Department of Obstetrics and Gynecology, University of Miami Miller School of Medicine, Miami, Florida., Woodham PC; Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Mercer University School of Medicine at the Medical Center Navicent Health, Macon, Georgia., Lazenby GB; Departments of Obstetrics and Gynecology and Medicine, Medical University of South Carolina, Charleston, South Carolina., Short WR; Division of Infectious Diseases, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania., Gillespie SE; Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia., Baldreldin N; Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois., Miller ES; Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois., Alleyne G; Division of Infectious Diseases and HIV Medicine, Drexel University School of Medicine, Philadelphia, Pennsylvania., Duthely LM; Department of Obstetrics and Gynecology, University of Miami Miller School of Medicine, Miami, Florida., Allen SM; Division of Infectious Diseases and HIV Medicine, Drexel University School of Medicine, Philadelphia, Pennsylvania., Levison J; Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas., Chakraborty R; Department of Pediatrics and Adolescent Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota.
Jazyk: angličtina
Zdroj: Open forum infectious diseases [Open Forum Infect Dis] 2019 Mar 18; Vol. 6 (4), pp. ofz129. Date of Electronic Publication: 2019 Mar 18 (Print Publication: 2019).
DOI: 10.1093/ofid/ofz129
Abstrakt: Background: There is a knowledge gap on the clinical use of elvitegravir (EVG) during pregnancy and maternal viral suppression. Our objective was to evaluate the effects of EVG use in pregnancy on rates of HIV virologic suppression and perinatal outcomes.
Methods: We conducted a retrospective, multicenter study of pregnant women living with HIV (WLHIV) who used EVG-containing antiretroviral therapy (ART) between January 2014 and March 2017 at 9 tertiary care centers in the United States. WLHIV were included if they took EVG at any time during pregnancy. We described the characteristics of the WLHIV using EVG during the study period and evaluated the rates of HIV suppression and perinatal outcomes.
Results: Among 134 pregnant WLHIV who received EVG at any time during pregnancy, viral suppression at delivery (HIV-1 RNA < 40 copies/mL) occurred in 81.3%. In WLHIV who initiated EVG before pregnancy and continued through delivery (n = 68), the rate of viral suppression at delivery was 88.2%. The average gestational age at the time of delivery was 37 weeks 6 days, and the overall rate of preterm birth was 20%. No cases of open neural tube defects were noted in women on EVG at the time of conception (n = 82). The perinatal HIV transmission rate was 0.8%.
Conclusions: EVG use was associated with high sustained levels of HIV suppression during pregnancy and a low rate of perinatal HIV transmission.
Databáze: MEDLINE
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