Risk of birth defects and perinatal outcomes in HIV-infected women exposed to integrase strand inhibitors during pregnancy.
Abnormalities, Drug-Induced
/ epidemiology
Congenital Abnormalities
/ epidemiology
Female
HIV Infections
/ drug therapy
HIV Integrase Inhibitors
/ adverse effects
Heterocyclic Compounds, 3-Ring
/ adverse effects
Humans
Infant, Newborn
Integrases
/ therapeutic use
Oxazines
/ therapeutic use
Piperazines
/ therapeutic use
Pregnancy
Premature Birth
Prospective Studies
Pyridones
Raltegravir Potassium
/ adverse effects
Journal
AIDS (London, England)
ISSN: 1473-5571
Titre abrégé: AIDS
Pays: England
ID NLM: 8710219
Informations de publication
Date de publication:
02 02 2021
02 02 2021
Historique:
pubmed:
14
10
2020
medline:
7
4
2021
entrez:
13
10
2020
Statut:
ppublish
Résumé
Following an alert on neural tube defects and dolutegravir, we sought to evaluate if the exposure integrase strand transfer inhibitors (INSTIs) at conception was associated with birth defects or other adverse pregnancy outcomes. In the prospective national French Perinatal Cohort (EPF), we studied birth defects and other perinatal outcomes by matching each pregnant woman exposed to INSTIs with a pregnant woman exposed to darunavir/ritonavir receiving the same backbone of nucleoside reverse transcriptase inhibitors and matched for other characteristics such as age, geographic origin, centre and year of delivery. Among 808 women exposed to INSTIs during pregnancy (raltegravir = 703, dolutegravir = 57 and elvitegravir = 48), we reported a slightly higher rate of birth defects in infants exposed at conception to raltegravir (6.7%) vs. infants exposed to raltegravir later in pregnancy: 2.9% if initiated during pregnancy as first-line, and 2.5% as second-line treatment, P =0.04. When compared with matched controls, raltegravir exposure at conception was not significantly associated with birth defects: 6.4 vs. 2.3%, P = 0.08. There was no cluster of birth defect type and no neural tube defects were observed. Other perinatal outcomes, such as preterm birth and stillbirths, did not differ significantly between raltegravir-exposed women and matched counterparts. No difference in any outcome was observed for elvitegravir/cobicistat or dolutegravir. We found a nonsignificant trend for an association between exposure to raltegravir at conception and birth defects, which needs to be evaluated by larger prospective surveillance data, as these drugs are increasingly prescribed in women living with HIV.
Identifiants
pubmed: 33048878
pii: 00002030-202102020-00006
doi: 10.1097/QAD.0000000000002719
doi:
Substances chimiques
HIV Integrase Inhibitors
0
Heterocyclic Compounds, 3-Ring
0
Oxazines
0
Piperazines
0
Pyridones
0
Raltegravir Potassium
43Y000U234
Integrases
EC 2.7.7.-
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
219-226Informations de copyright
Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.
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