HIV in pregnancy
From IDWiki
Management
Initial regimens for treatment-naive women
- NRTI backbones
- ABC/3TC
- TDF/FTC or TDF/3TC
- INSTI regimens
- DTG/ABC/3TC
- DTG and an NRTI backbone
- PI regimens
- ATV/r and an NRTI backbone
- DRV/r and an NRTI backbone
Safety in pregnancy
| Drug | Starting | Continuing | Restarting | Conceiving |
|---|---|---|---|---|
| NRTIs | ||||
| ABC | Preferred | Continue | Preferred | Preferred |
| FTC | Preferred | Continue | Preferred | Preferred |
| 3TC | Preferred | Continue | Preferred | Preferred |
| TDF | Preferred | Continue | Preferred | Preferred |
| ZDV | Alternative | Continue | Alternative | Alternative |
| TAF | No data | Continue | No data | No data |
| Integrase Inhibitors | ||||
| DTG | Avoid in T1, then preferred |
Avoid in T1 | Avoid in T1 | Not recommended |
| RAL | Preferred | Continue | Preferred | Preferred |
| BIC | No data | No data | No data | No data |
| EVG/COBI | Not recommended | Consider switch | Not recommended | Not recommended |
| Protease Inhibitors | ||||
| ATV/r | Preferred | Continue | Preferred | Preferred |
| DRV/r | Preferred | Continue | Preferred | Preferred |
| LPV/r | Alternative | Continue | Alternative | Alternative |
| ATV/COBI | Not recommended | Consider switch | Not recommended | Not recommended |
| DRV/COBI | Not recommended | Consider switch | Not recommended | Not recommended |
| NNRTIs | ||||
| EFV | Alternative | Continue | Alternative | Alternative |
| RPV | Alternative | Continue | Alternative | Alternative |
| DOR | No data | No data | No data | No data |
| ETR | Not recommended | Continue | Not recommended | Not recommended |
| NVP | Not recommended | Continue | Not recommended | Not recommended |
| Entry Inhibitors & Fusion Inhibitors | ||||
| IBA | No data | No data | No data | No data |
| MVC | Not recommended | Continue | Not recommended | Not recommended |
| T-20 | Not recommended | Continue | Not recommended | Not recommended |
| Fixed Drug Combinations | ||||
| ABC/DTG/3TC | Avoid T1 (DTG), then preferred |
Consider switch if T1 | Avoid T1 (DTG), then preferred |
Not recommended (DTG) |
| EFV/FTC/TDF | Alternative (EFV) | Continue | Alternative (EFV) | Alternative (EFV) |
| EFC/3TC/TDF | Alternative (EFV) | Continue | Alternative (EFV) | Alternative (EFV) |
| FTC/RPV/TDF | Alternative (RPV) | Continue (RPV) | Alternative (RPV) | Alternative (RPV) |
| BIC/FTC/TAF | No data (BIC/TAF) | No data (BIC) | No data (BIC/TAF) | No data (BIC/TAF) |
| DOR/3TC/TDF | No data (DOR) | No data (DOR) | No data (DOR) | No data (DOR) |
| FTC/RPV/TAF | No data (TAF) | Continue (RPV/TAF) | No data (TAF) | No data (TAF) |
| EVG/c/FTC/TDF | Not recommended (EVG/c) | Consider switch | Not recommended (EVG/c) | Not recommended (EVG/c) |
| EVG/c/FTC/TAF | Not recommended (EVG/c) | Consider switch | Not recommended (EVG/c) | Not recommended (EVG/c) |
| DRV/c/FTC/TAF | Not recommended (DRV/c) | Consider switch | Not recommended (DRV/c) | Not recommended (DRV/c) |
| DTG/RPV | Not recommended | Consider switch | Not recommended | Not recommended |
- Starting = ART for Pregnant Women Who Have Never Received ARV Drugs and Who Are Initiating ART for the First Time
- Continuing = Continuing ART for Women Who Become Pregnant on an ART Regimen that has been Well Tolerated and Virologically Suppressive
- Restarting = ART for Pregnant Women Who Have Received ARV Drugs in the Past and Who Are Restarting ART
- Conceiving = ART for Nonpregnant Women Who Are Trying to Conceive
