Tenofovir Use Safe During Pregnancy

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.

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.”

Reference

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