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Integrase Inhibitors Use for HIV Infection in Pregnancy

  • HIV/AIDs (C Yoon, Section Editor)
  • Published:
Current Infectious Disease Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

There are important unmet needs regarding HIV infection, particularly in vulnerable population, such as pregnant women and the safety and efficacy of antiretrovirals to them and their newborn. HIV integrase inhibitor agents are among the preferred antiretrovirals in most guidelines worldwide. The purpose of this review is to evaluate their safety and efficacy in that specific population.

Recent Findings

An increased importance it is being paid to this issue. However, only recently and just a few studies have been conducted trying to evaluate and compare these drugs with other agents such as efavirenz and protease inhibitors.

Summary

Most studies evaluate dolutegravir and some raltegravir. So far, the findings from clinical trials support the indication of dolutegravir as the preferred agent and raltegravir as the alternate drug in pregnant women and in those who can become pregnant. They have been shown to be safe to the mother and infant and are effective in reducing viral load and prevent maternal-to-child HIV transmission. Furthermore, viral decay is faster with them, which could be important for late pregnancy in women not taking antiretrovirals yet. While elvitegravir is not recommended due to pharmacokinetic limitations, bictegravir is still not indicated as there is virtually no information about its use in this population. More clinical trials and data are urgently needed to better evaluate antiretrovirals for pregnant women in several settings, including preconception; first, second, and third trimester; and post-partum.

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Papers of particular interest, published recently, have been highlighted as: • Of importance

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Acknowledgements

We thank Lucca S. Souza for his contribution in the review of the manuscript.

Funding

This work was partially supported by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brasil (CAPES) [Finance Code 001].

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Authors and Affiliations

  1. Programa de Pós-Graduação Em Medicina E Saúde (PPgMS), Universidade Federal da Bahia, Salvador, Bahia, Brazil

    Sávio Amaral & Carlos Brites

  2. Laboratório de Pesquisa Em Infectologia (LAPI), Hospital Universitário Prof. Edgard Santos (HUPES), Universidade Federal da Bahia, Salvador, Bahia, Brazil

    Sávio Amaral & Carlos Brites

  3. Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil

    Eduardo Sprinz

  4. Faculdade de Medicina, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Rio Grande do Sul, Brazil

    Eduardo Sprinz

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  1. Sávio Amaral
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Contributions

All authors contributed to the study. Material preparation and data collection were performed by Sávio Amaral. The first draft of the manuscript was written by Sávio Amaral and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Eduardo Sprinz.

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Amaral, S., Brites, C. & Sprinz, E. Integrase Inhibitors Use for HIV Infection in Pregnancy. Curr Infect Dis Rep 24, 9–19 (2022). https://doi.org/10.1007/s11908-022-00774-5

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