PMID- 31893354 OWN - NLM STAT- MEDLINE DCOM- 20200402 LR - 20210201 IS - 1439-0973 (Electronic) IS - 0300-8126 (Linking) VI - 48 IP - 2 DP - 2020 Apr TI - Pregnancy and neonatal outcomes in women with HIV-1 exposed to integrase inhibitors, protease inhibitors and non-nucleoside reverse transcriptase inhibitors: an observational study. PG - 249-258 LID - 10.1007/s15010-019-01384-5 [doi] AB - PURPOSE: Recommended regimens for pregnant women with HIV-1 are composed of two nucleoside reverse transcriptase inhibitors (NRTI) plus either a ritonavir-boosted protease inhibitor (PI) or an integrase strand transfer inhibitor (ISTI), with non-nucleoside reverse transcriptase inhibitors (NNRTI) representing an alternative drug class. The study's purpose was to compare these three options in terms of pregnancy outcomes. METHODS: Data from a national observational study of pregnant women with HIV-1 were used. The analysis included all pregnancies reported between 2008 and 2018, ending in live births and exposed within 32 weeks of gestation to three-drug regimens composed of a NRTI backbone plus a PI, a NNRTI or a ISTI, without class switching during pregnancy. Clinical and laboratory outcomes were evaluated in univariate and multivariable analyses. RESULTS: Overall, 794 exposed pregnancies were analyzed (PI 78.4%, NNRTI 15.4%, ISTI 6.2%). Almost all outcomes had similar rates in the three groups. Women who received PI in pregnancy were less likely to be virologically suppressed at third trimester. PI use was associated with higher bilirubin and triglyceride levels, and ISTI use with a lower rate of low birthweight. The differences in viral suppression at third trimester and in low birthweight were not maintained in multivariable analyses that were adjusted for confounders. DISCUSSION: We found no major differences in a wide range of outcomes relevant for pregnant women with HIV. Such results are reassuring, and this information may be helpful in a context of preconception counseling when therapeutic choices for pregnancy are discussed between women and care providers. FAU - Floridia, Marco AU - Floridia M AUID- ORCID: 0000-0003-3971-0141 AD - National Center for Global Health, Istituto Superiore di Sanita, Viale Regina Elena 299, 00161, Rome, Italy. marco.floridia@iss.it. FAU - Dalzero, Serena AU - Dalzero S AD - Department of Obstetrics and Gynaecology, DMSD San Paolo Hospital Medical School, University of Milan, Milan, Italy. FAU - Giacomet, Vania AU - Giacomet V AD - Department of Pediatrics, Luigi Sacco Hospital and University of Milan, Milan, Italy. FAU - Tamburrini, Enrica AU - Tamburrini E AD - Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. AD - Catholic University of the Sacred Heart, Rome, Italy. FAU - Masuelli, Giulia AU - Masuelli G AD - Department of Obstetrics and Neonatology, Citta della Salute e della Scienza Hospital, University of Turin, Turin, Italy. FAU - Savasi, Valeria AU - Savasi V AD - Department of Obstetrics and Gynaecology, Luigi Sacco Hospital and University of Milan, Milan, Italy. FAU - Spinillo, Arsenio AU - Spinillo A AD - Department of Obstetrics and Gynaecology, IRCCS S. Matteo, Pavia, Italy. FAU - Tassis, Beatrice AU - Tassis B AD - Obstetrics and Gynecology Unit, Fondazione IRCCS Ospedale Maggiore Policlinico di Milano, Milan, Italy. FAU - Franceschetti, Laura AU - Franceschetti L AD - Department of Obstetrics and Gynecology, ASST Spedali Civili, Brescia, Italy. FAU - Degli Antoni, Anna Maria AU - Degli Antoni AM AD - Department of Infectious Diseases and Hepatology, Azienda Ospedaliera di Parma, Parma, Italy. FAU - Sansone, Matilde AU - Sansone M AD - Department of Neurosciences, Reproductive and Dentistry Science, University Federico II, Naples, Italy. FAU - Guaraldi, Giovanni AU - Guaraldi G AD - Department of Medical Specialties, Infectious Diseases Clinic, University of Modena and Reggio Emilia, Modena, Italy. FAU - Vimercati, Antonella AU - Vimercati A AD - Department of Biomedical and Human Oncological Science (DIMO), 2nd Unit of Obstetrics and Gynaecology, University of Bari, Bari, Italy. FAU - Meloni, Alessandra AU - Meloni A AD - Department of Surgical Sciences, Division of Gynaecology and Obstetrics, University of Cagliari, Cagliari, Italy. FAU - Ravizza, Marina AU - Ravizza M AD - Department of Obstetrics and Gynaecology, DMSD San Paolo Hospital Medical School, University of Milan, Milan, Italy. CN - Italian Group on Surveillance of Antiretroviral Treatment in Pregnancy LA - eng GR - H85E08000200005/Agenzia Italiana del Farmaco, Ministero della Salute/ PT - Journal Article PT - Observational Study DEP - 20200101 PL - Germany TA - Infection JT - Infection JID - 0365307 RN - 0 (Anti-HIV Agents) RN - 0 (Integrase Inhibitors) RN - 0 (Protease Inhibitors) RN - 0 (RNA, Viral) RN - 0 (Reverse Transcriptase Inhibitors) SB - IM CIN - Infection. 2020 Apr;48(2):311-312. PMID: 32026311 MH - Adult MH - Anti-HIV Agents/adverse effects/*therapeutic use MH - Birth Weight MH - Female MH - HIV Infections/*drug therapy MH - HIV-1 MH - Humans MH - Integrase Inhibitors/adverse effects/*therapeutic use MH - Multivariate Analysis MH - Pregnancy MH - Pregnancy Outcome MH - Protease Inhibitors/adverse effects/*therapeutic use MH - RNA, Viral/blood MH - Reverse Transcriptase Inhibitors/adverse effects/*therapeutic use OTO - NOTNLM OT - Delivery complications OT - HIV OT - HIV suppression OT - Low birthweight OT - Pregnancy OT - Preterm delivery EDAT- 2020/01/02 06:00 MHDA- 2020/04/03 06:00 CRDT- 2020/01/02 06:00 PHST- 2019/09/17 00:00 [received] PHST- 2019/12/15 00:00 [accepted] PHST- 2020/01/02 06:00 [pubmed] PHST- 2020/04/03 06:00 [medline] PHST- 2020/01/02 06:00 [entrez] AID - 10.1007/s15010-019-01384-5 [pii] AID - 10.1007/s15010-019-01384-5 [doi] PST - ppublish SO - Infection. 2020 Apr;48(2):249-258. doi: 10.1007/s15010-019-01384-5. Epub 2020 Jan 1.