HealthDay News — For HIV-infected women and their infants, the risk of adverse birth outcomes is similar with tenofovir, emtricitabine, and ritonavir-boosted lopinavir (TDF-FTC-LPV/r) compared with zidovudine, lamivudine, and ritonavir-boosted lopinavir (ZDV-3TC-LPV/r) or TDF-FTC with ritonavir-boosted atazanavir (ATV/r), according to a study published in the April 26 issue of the New England Journal of Medicine.
Kathryn Rough, ScD, from Harvard Medical School in Boston, and colleagues compared the risks of adverse birth outcomes among infants with in utero exposure to the 3 regimens, using data from two U.S.-based cohort studies.
The researchers identified 4,646 birth outcomes. Overall, 2.8% of infants or fetuses were exposed to TDF-FTC-LPV/r as the initial antiretroviral therapy regimen during gestation. This is in contrast with 11.6 exposed to TDF-FTC-ATV/r and 20.5% exposed to ZDV-3TC-LPV/r. Women receiving TDF-FTC-LPV/r had a similar risk of preterm birth (risk ratio, 0.90; 95% confidence interval [CI], 0.60 to 1.33) and low birth weight (risk ratio, 1.13; 95% CI, 0.78 to 1.64) compared with women receiving ZDV-3TC-LPV/r. Women receiving TDF-FTC-LPV/r had a similar or slightly higher risk of preterm birth (risk ratio, 1.14; 95% CI, 0.75 to 1.72) and low birth weight (risk ratio, 1.45; 95% CI, 0.96 to 2.17) compared to women receiving TDF-FTC-ATV/r.
“The risk of adverse birth outcomes was not higher with TDF-FTC-LPV/r than with ZDV-3TC-LPV/r or TDF-FTC-ATV/r among HIV-infected women and their infants in the United States,” the authors write.