PMID- 28426519
OWN - NLM
STAT- MEDLINE
DCOM- 20180104
LR  - 20181202
IS  - 1746-6318 (Electronic)
IS  - 1746-630X (Print)
IS  - 1746-630X (Linking)
VI  - 12
IP  - 4
DP  - 2017 Jul
TI  - Toward a universal antiretroviral regimen: special considerations of pregnancy 
      and breast feeding.
PG  - 359-368
LID - 10.1097/COH.0000000000000386 [doi]
AB  - PURPOSE OF REVIEW: As optimized antiretroviral therapy (ART) regimens are 
      prepared for introduction in low-income and middle-income countries (LMIC), we 
      consider the current evidence related to dosing, efficacy and safety during 
      pregnancy and breastfeeding of next-generation first-line and second-line ART 
      regimens proposed for imminent introduction in the global marketplace. RECENT 
      FINDINGS: Pregnancy pharmacokinetic considerations include potentially 
      insufficient efavirenz exposure if dosed at 400 mg/day, the need for twice daily 
      darunavir dosing and the paucity of data related to tenofovir alafenamide and 
      dolutegravir dosing, safety and efficacy. Increasingly evidence suggests an 
      association with adverse birth outcomes, particularly in women conceiving on ART, 
      and with varying risk by drug and drug combination. Clinical trials and studies 
      are in progress or planned that aim to determine dosing, safety and efficacy of 
      several new antiretrovirals (ARVs). SUMMARY: Having a universal, highly potent 
      and safe ART regimen for all individuals living with HIV in LMIC including 
      pregnant women is clearly the most beneficial strategy to keep mothers alive and 
      healthy and to prevent transmission of HIV to their children. It will have to be 
      determined whether the use of this next generation of optimized ARVs will also 
      optimize health outcomes of pregnant women and their children.
FAU - Slogrove, Amy L
AU  - Slogrove AL
AD  - aCentre for Infectious Disease Epidemiology and Research, School of Public Health 
      and Family Medicine, University of Cape Town bDepartment of Paediatrics and Child 
      Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape 
      Town, South Africa cHIV i-Base, London, UK dICAP at Columbia University, Mailman 
      School of Public Health eCollege of Physicians and Surgeons, Columbia University, 
      New York, New York, USA.
FAU - Clayden, Polly
AU  - Clayden P
FAU - Abrams, Elaine J
AU  - Abrams EJ
LA  - eng
GR  - R01 HD074558/HD/NICHD NIH HHS/United States
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Curr Opin HIV AIDS
JT  - Current opinion in HIV and AIDS
JID - 101264945
RN  - 0 (Anti-HIV Agents)
SB  - IM
MH  - Anti-HIV Agents/*therapeutic use
MH  - *Breast Feeding
MH  - Clinical Trials as Topic
MH  - Dose-Response Relationship, Drug
MH  - Female
MH  - HIV Infections/prevention & control/*transmission
MH  - Humans
MH  - Infectious Disease Transmission, Vertical/*prevention & control
MH  - Pregnancy
MH  - Pregnancy Complications, Infectious
PMC - PMC5584561
MID - NIHMS892686
COIS- Conflicts of interest: Elaine J Abrams has participated in advisory boards for 
      Merck Pharmaceuticals and Viiv Pharmaceuticals. Amy L. Slogrove and Polly Clayden 
      have no conflicts of interest to declare.
EDAT- 2017/04/21 06:00
MHDA- 2018/01/05 06:00
PMCR- 2018/07/01
CRDT- 2017/04/21 06:00
PHST- 2017/04/21 06:00 [pubmed]
PHST- 2018/01/05 06:00 [medline]
PHST- 2017/04/21 06:00 [entrez]
PHST- 2018/07/01 00:00 [pmc-release]
AID - 10.1097/COH.0000000000000386 [doi]
PST - ppublish
SO  - Curr Opin HIV AIDS. 2017 Jul;12(4):359-368. doi: 10.1097/COH.0000000000000386.