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antiretroviral therapies HIV-1 pregnancy | News


For instant launch: September 1, 2022

Boston, MA— Dolutegravir-based antiretroviral therapies (ART) for HIV-1 are more practical for pregnant people than another ART regimens generally used within the U.S. and Europe, in line with a research led by Harvard T.H. Chan School of Public Health researchers.

The study, printed on-line in NEJM on September 1, 2022, confirmed that pregnant individuals who took dolutegravir-based regimens had a excessive chance of being virally suppressed at supply. There had been no noticed variations within the dangers of opposed start outcomes (preterm start, low start weight, small for gestational age, or neonatal demise) between dolutegravir-based regimens and the opposite up to date regimens.

“Globally, a dolutegravir-based regimen is currently recommended for treating HIV, and this is the first study to directly compare regimens including dolutegravir to other antiretroviral regimens, such as raltegravir-based regimens, that are also listed as ‘Preferred’ in U.S. perinatal guidelines” stated Kunjal Patel, senior analysis scientist within the Department of Epidemiology at Harvard Chan School and lead creator of the research.

Dolutegravir, a extra just lately accredited antiretroviral drug, is a part of a once-a-day routine that has been proven to be more practical, simpler to tolerate, and fewer more likely to create new drug resistance in folks with HIV-1 in contrast with different antiretroviral medication. However, restricted information have been obtainable about its effectiveness and security in pregnancy in contrast with regimens that generally have been used throughout pregnancy within the U.S. and Europe.

In the present observational research, the researchers in contrast dolutegravir use in pregnancy with atazanavir/ritonavir, darunavir/ritonavir, and raltegravir antiviral regimens which might be at present categorized as “Preferred” to be used in pregnancy within the U.S. About half of the individuals began ART earlier than conception. At supply, 96.7% of pregnancies of individuals who obtained dolutegravir had been virally suppressed, whereas these of individuals who took atazanavir/ritonavir or raltegravir had viral suppression of 84.0% and 89.2%, respectively.

“We think the observed differences are due to dolutegravir’s ability to rapidly decrease viral loads and its ease of use as part of a once-daily regimen that’s available as a fixed-dose combination,” stated Patel. “Our results highlight the continual need for systematic studies that compare new antiretroviral regimens with those already in clinical practice to help inform the evolution of guidelines and clinical practice over time.”

Other Harvard Chan co-authors embody Yanling Huo, Paige Williams, Deborah Kacanek, Denise Jacobson, Sean Brummel, and George Seage. The authors dedicate this work to the reminiscence of their colleague and buddy, Seage, who handed away in 2020.

This analysis was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, National Institute of Dental and Craniofacial Research, National Institute of Allergy and Infectious Diseases, National Institute of Neurological Disorders and Stroke, National Institute on Deafness and Other Communication Disorders, National Institute of Mental Health, National Institute on Drug Abuse, National Cancer Institute, National Institute on Alcohol Abuse and Alcoholism, National Heart, Lung, and Blood Institute (grants U01HD052102, U01HD052104, and P01HD103133), and the Swiss National Science Foundation (grant 201369).

“Dolutegravir in Pregnancy as Compared with Current HIV Regimens in the United States,” Kunjal Patel, Yanling Huo, Jennifer Jao, Kathleen M. Powis, Paige L. Williams, Deborah Kacanek, Lynn M. Yee, Ellen G. Chadwick, Stephanie Shiau, Denise L. Jacobson, Sean S. Brummel, Leila Sultan-Beyer, Christian R. Kahlert, Rebecca Zash, and George R. Seage III, for the Pediatric HIV/AIDS Cohort Study and the Swiss Mother and Child HIV Cohort Study, NEJM, on-line September 1, 2022, doi: 10.1056/NEJMoa2200600.

Visit the Harvard Chan School web site for the latest newspress releases, and multimedia offerings.

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Harvard T.H. Chan School of Public Health brings collectively devoted specialists from many disciplines to teach new generations of worldwide well being leaders and produce highly effective concepts that enhance the lives and well being of individuals all over the place. As a group of main scientists, educators, and college students, we work collectively to take revolutionary concepts from the laboratory to folks’s lives—not solely making scientific breakthroughs, but additionally working to alter particular person behaviors, public insurance policies, and well being care practices. Each yr, greater than 400 college members at Harvard Chan School educate 1,000-plus full-time college students from around the globe and practice hundreds extra via on-line and government training programs. Founded in 1913 because the Harvard-MIT School of Health Officers, the School is acknowledged as America’s oldest skilled coaching program in public well being.





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