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Journal article
Evaluating outcomes of mother-infant pairs using dolutegravir for HIV treatment during pregnancy
AIDS (London), v 32(14), pp 2017-2021
10 Sep 2018
PMID: 29944472
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Objectives: Dolutegravir (DTG), a second-generation integrase inhibitor, is an effective treatment for HIV but its safety and efficacy are not well established in pregnancy. Here, we assess maternal and infant outcomes of mother-infant pairs using DTG-containing regimens during pregnancy.
Methods: We performed a retrospective cohort analysis of pregnant women with HIV on DTG from two urban clinics in the United States, 2015-2018. Maternal outcomes included viral suppression (viral load of <20 copies/ml prior to delivery), development of resistance, and tolerability to DTG. Infant outcomes included preterm delivery (birth at <37 weeks), small for gestational age (SGA, weight <10th percentile), infant HIV status at birth, birth defect(s), and Appearance, Pulse, Grimace, Activity, Respiration (APGAR) scores. We performed a trend analysis to assess DTG use over time.
Results: A total of 66 women used DTG during pregnancy and the proportion on DTG increased each year: in 2015, 8% (5/60) of women were on DTG, versus 22% (15/67) in 2016, 42% (30/71) in 2017, and 59% (16/27) in 2018 (P < 0.05). Among women who delivered (n = 57), 77.2% were undetectable at delivery. There were no drug resistance and no reported side effects during pregnancy. Infants had a mean APGAR score of 8 (SD 1.5) at 1 min and 9 (SD 0.8) at 5 min; 31.6% were born prematurely and 15.8% were SGA, and 2 infants had a birth defect. No cases of HIV transmission occurred.
Conclusion: Our findings suggest that DTG can be an effective treatment during pregnancy. Infant outcomes (preterm deliveries and birth defects) need to be investigated in larger studies. Copyright (C) 2018 The Author(s). Published by Wolters Kluwer Health, Inc.
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Details
- Title
- Evaluating outcomes of mother-infant pairs using dolutegravir for HIV treatment during pregnancy
- Creators
- Clara Grayhack - Drexel UniversityAnandi Sheth - Emory UniversityOlivia Kirby - Drexel UniversityJennifer Davis - Emory UniversityKedesha Sibliss - Drexel UniversityHervette Nkwihoreze - Drexel UniversityErika Aaron - AIDS Activities Coordinating OfficeGregg Alleyne - Drexel UniversityRoberta Laguerre - Drexel UniversityAadia Rana - University of Alabama at BirminghamMartina Badell - Emory UniversityFlorence Momplaisir - Drexel University
- Publication Details
- AIDS (London), v 32(14), pp 2017-2021
- Publisher
- Lippincott Williams & Wilkins
- Number of pages
- 5
- Grant note
- K23 AI114407 / NIAID NIH HHS; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Allergy & Infectious Diseases (NIAID) K23AI114407 / NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Allergy & Infectious Diseases (NIAID)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Pediatrics; Infectious Diseases (and HIV Medicine)
- Web of Science ID
- WOS:000453902200012
- Scopus ID
- 2-s2.0-85060372679
- Other Identifier
- 991019168347104721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Immunology
- Infectious Diseases
- Virology