“The info collected up to now on tenofovir disoproxil fumarate (TDF)-based HIV pre-exposure prophylaxis (PrEP) use throughout being pregnant are reassuring, indicating that the frequency of adversarial being pregnant, delivery, and toddler development outcomes amongst moms and infants uncovered to TDF-based PrEP in being pregnant isn’t any extra widespread than that skilled by moms or infants with out TDF publicity,” in response to findings of a security evaluation printed in Professional Opinion on Drug Security.
Authors reviewed a number of research that evaluated the protection of PrEP in pregnant girls, together with the Companions PrEP Research, TDF2 Research, FEM-PrEP, and VOICE. In all 4 trials, investigators discovered that the frequency of adversarial being pregnant outcomes didn’t differ considerably between the energetic PrEP routine and the placebo arms. Within the FEM-PrEP research, full information weren’t reported on being pregnant issues, however it was famous that vaginal bleeding was the commonest complication. Within the VOICE research, subsequent follow-up confirmed no distinction between the PrEP and placebo arms in development indicators within the first yr of life in infants born to enrolled moms.
Research with pregnant girls dwelling with HIV had completely different findings than beforehand talked about. A meta-analysis noticed considerably decrease charges of preterm supply and stillbirth amongst girls who acquired TDF-based antiretroviral remedy in contrast with girls who didn’t obtain TDF-based regimens. Nevertheless, the PROMISE trial confirmed that girls who acquired TDF-based remedy have been extra more likely to have preterm supply and neonatal mortality in contrast with girls who acquired zidovudine-based remedy however not compared with girls utilizing zidovudine alone. One other research confirmed that adjusted imply length-for-age and head circumference z-scores at 1 yr of age have been smaller amongst kids whose moms used TDF-based remedy throughout being pregnant.
The next are potential various PrEP therapies for pregnant girls: tenofovir alafenamide with emtricitabine; dapivirine vaginal ring; and cabotegravir injectable.
“Whereas present information are reassuring on security in being pregnant, extra strong information from potential research and implementation tasks that actively recruit girls previous to conception or throughout being pregnant are nonetheless important to raised perceive the pharmacokinetics, security, and efficacy of TDF-based PrEP in being pregnant,” research authors concluded.
Stalter RM, Pintye J, Mugwanya KK. Security evaluation of tenofovir disoproxil fumarate/emtricitabine pre-exposure prophylaxis for pregnant girls susceptible to HIV an infection. Professional Opin Drug Saf. Printed on-line Might 28, 2021. doi:10.1080/14740338.2021.1931680