Tenofovir Use Safe During Pregnancy

pregnant woman
pregnant woman
Further research on longer-term effects of maternal prenatal TDF use is important given the majority of HIV-infected women are prescribed a TDF-containing prevention of mother-to-child transmission regimen.

Tenofovir used as part of 3-drug antiretroviral regimen during pregnancy did not have an adverse impact on perinatal outcomes, according to the results of a study published in The Journal of Infectious Diseases.

In this prospective study, pregnancy outcomes were compared between women receiving tenofovir as part of a 3-drug antiretroviral regimen and women receiving an alternative 3-drug regimen. A total of 422 women from Kenya and Uganda living with HIV with singleton pregnancies not terminated by an induced abortion were included (median age 25.4 years; 21% primigravida).

Tenofovir combined with lamivudine and efavirenz was the most common antiretroviral regimen (39%) followed by zidovudine combined with lamivudine and nevirapine (34%). In total, 49% of women used tenofovir during pregnancy, and 6% used a protease inhibitor.

Among women with exposure to tenofovir during pregnancy, no difference in pregnancy loss (14% vs 9%; prevalence ratio [PRR] 1.63; P =.2), neonatal death (1% vs 2%; PRR 0.82; P =.8), or preterm birth (6% vs 10%; PRR 0.55; P =.1).

After adjustment for study cohort, maternal age, time since maternal HIV diagnosis, and HIV RNA viral load at first pregnancy visit, use of tenofovir during pregnancy was associated with a decreased risk for preterm birth (adjusted PRR 0.34; P =.02). The effect of tenofovir on pregnancy loss and neonatal death remained nonsignificant after adjustment.

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The study authors called the findings “reassuring,” and indicated that they “complement the growing body of literature indicating that [tenofovir] use during pregnancy is not associated with adverse perinatal outcomes compared to non-[tenofovir]-containing [antiretroviral therapy] regimens.”


Pintye J, Baeten JM, Celum C, et al. Maternal tenofovir disoproxil fumarate use during pregnancy is not associated with adverse perinatal outcomes among HIV-infected East African women: a prospective study [published online October 10, 2017]. J Infect Dis. doi: 10.1093/infdis/jix542