Fetal biometry following in-utero exposure to dolutegravir-based or efavirenz-based antiretroviral therapy.
Fetal biometry following in-utero exposure to dolutegravir-based or efavirenz-based antiretroviral therapy.
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DOI：
10.1097/qad.0000000000002674
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发表时间：
2020-12-01
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世卫组织建议将dolutegravir作为艾滋病毒感染者一线抗逆转录病毒治疗（ART）的一部分[1]。因此，感染艾滋病毒的孕妇（WLHIV）越来越多地接受全世界基于度鲁特韦的抗逆转录病毒治疗。尽管一些研究报告了该人群的出生结局[2]，但没有关于妊娠WLHIV患者接受度鲁特韦治疗的胎儿生物学数据。我们评估了基于度鲁特韦或依法韦仑的ART与胎儿生物统计学的关联，使用HIV/ART未暴露胎儿的对照组。我们从2016年8月至2019年5月在博茨瓦纳的Tshilo Dikotla队列中招募了妊娠16至36周的WLHIV孕妇和未携带HIV的孕妇。WLHIV在怀孕期间接受替诺福韦和恩曲他滨以及dolutegravir（基于dolutegravir的ART）或efavirenz（基于efavirenz的ART）。排除多胎妊娠或胎儿死亡的妊娠。这项研究得到了博茨瓦纳人类研究与发展委员会、西北大学范伯格医学院机构审查委员会以及安和罗伯特H。芝加哥卢瑞儿童医院。
The WHO recommends dolutegravir as part of firstline antiretroviral therapy (ART) for persons living with HIV [1]. Consequently, pregnant women living with HIV (WLHIV) are increasingly receiving dolutegravir-based ART worldwide. Although some studies have reported on birth outcomes in this population [2], there are no data on fetal biometry in pregnant WLHIV receiving dolutegravir. We assessed the association of dolutegravir-based or efavirenz-based ART with fetal biometry, using a comparison group of HIV/ART-unexposed fetuses.We enrolled pregnant WLHIV and pregnant women without HIV between 16 and 36 weeks gestation in the Tshilo Dikotla cohort in Botswana from August 2016 to May 2019. WLHIV received tenofovir and emtricitabine and either dolutegravir (dolutegravir-based ART) or efavirenz (efavirenz-based ART) during pregnancy. Pregnancies with multiple gestations or ending in fetal demise were excluded. The study was approved by the Human Research and Development Committee in Botswana and the Institutional Review Boards at Northwestern University Feinberg School of Medicine and the Ann and Robert H. Lurie Children’s Hospital of Chicago.