Birth Outcomes for Pregnant Women With HIV Using Tenofovir-Emtricitabine

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(Abstracted from N Engl J Med 2018;378:1593–1603)Three-drug antiretroviral therapy (ART) during pregnancy has reduced the risk of perinatal transmission of HIV to less than 1% and has become the global standard of care. The Promoting Maternal and Infant Survival Everywhere (PROMISE) trial recently found that pregnant women in multiple sites of sub-Saharan Africa and India receiving tenofovir, disoproxil fumarate, emtricitabine, and ritonavir-boosted lopinavir (TDF-FTC-LPV/r) were more than twice as likely to deliver very prematurely (<34 weeks of gestation), at very low birth weight (<1500 g), and were significantly more likely to have infants that died within 14 days after delivery compared with those assigned to receive zidovudine, lamivudine, and ritonavir-boosted lopinavir (ZDV-3TC-LPV/r).

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