Use of Antiretroviral Therapy During Pregnancy and Adverse Birth Outcomes Among Women Living With HIV-1 in Low- and Middle-Income Countries: A Systematic Review

Journal of Acquired Immune Deficiency Syndromes : JAIDS
Jessica Londeree SaleskaJesse J Kwiek

Abstract

Worldwide, nearly 18 million women of reproductive age are living with HIV-1. Although increased access to antiretroviral therapy (ART) during pregnancy has significantly reduced HIV-1 mother-to-child transmission (MTCT), a similarly robust reduction in preterm birth (PTB) and low birthweight (LBW) among infants born to women living with HIV has not been observed. This study was designed to identify associations between classes of ART regimens and risk of PTB or LBW. Low- and middle-income countries. We conducted a systematic review of randomized and observational studies that assessed the effect of ART regimen on the risk of PTB (≤37 completed weeks of gestation) or LBW (<2500 g at birth) among pregnant women in low- and middle-income countries living with HIV-1. We searched Medline, COCHRANE, Web of Science, SCOPUS, and CPCI-S for included studies. When compared to monotherapy, both nonnucleoside reverse transcriptase inhibitor- and protease inhibitor-based regimens had a consistent, harmful association with LBW. There is mixed evidence suggesting both potential harm and potential benefit for most other regimens on risk of LBW and PTB, and the harmful or protective effects of certain regimens varies depending on the drug back...Continue Reading

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Citations

Apr 8, 2020·American Journal of Reproductive Immunology : AJRI·Krithi RaviJoris Hemelaar
Jun 4, 2020·Paediatric and Perinatal Epidemiology·Angela M BengtsonLandon Myer
Feb 25, 2019·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·Junpeng ZhaoLunan Wang
Nov 13, 2020·The Pediatric Infectious Disease Journal·Debika BhattacharyaJudith S Currier
Jan 23, 2021·The Pediatric Infectious Disease Journal·Micah PiskeUNKNOWN CIHR Team Grant on Cellular Aging and HIV Comorbidities in Women and Children
May 1, 2021·Cells·Laura CheneyJoan W Berman

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