Is PrEP necessary during natural conception in HIV-1-serodiscordant couples on ART with suppressed viral load? A retrospective cohort analysis

BMC Infectious Diseases
Lijun SunHui Wang

Abstract

Antiretroviral therapy (ART) demonstrates high efficacy in reducing the risk of HIV transmission to sexual partners. However, it is not clear if the use of pre-exposure prophylaxis (PrEP) in HIV-1-serodiscordant couples is necessary during natural conception when the HIV-positive partner exhibits a suppressed viral load. The purpose of this study was to assess the role of PrEP during natural conception in this population. A retrospective, multicenter study was conducted in a cohort of HIV-1-serodiscordant couples (positive man, negative woman) with childbearing desires. HIV-positive male partners were treated with ART and achieved viral suppression for more than half a year. The HIV-negative female partners were either treated with PrEP or not treated with PrEP, and outcomes were compared between the two treatment groups. Of 246 HIV-1-serodiscordant couples in whom the HIV-positive partner achieved viral suppression, 104 seronegative women were treated with PrEP during natural conception and 142 seronegative women were not treated with PrEP. There were 410 condom-less sexual acts in couples treated with PrEP and 615 condom-less sexual acts in couples not treated with PrEP. We observed no instances of HIV transmission in HIV-1-s...Continue Reading

References

Sep 28, 2006·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Pablo BarreiroUNKNOWN Spanish HIV-Discordant Study Group
Jul 20, 2011·The New England Journal of Medicine·Myron S CohenUNKNOWN HPTN 052 Study Team
Sep 14, 2012·Science Translational Medicine·Peter L AndersonUNKNOWN iPrEx Study Team
Feb 24, 2015·JAMA Internal Medicine·Jacek SkarbinskiJonathan H Mermin
Jul 13, 2016·JAMA : the Journal of the American Medical Association·Alison J RodgerUNKNOWN PARTNER Study Group
Jul 19, 2016·The New England Journal of Medicine·Myron S CohenUNKNOWN HPTN 052 Study Team
Aug 18, 2016·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Susan H EshlemanMyron S Cohen

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