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UK guidelines on treatment of HIV in pregnancy give green light to efavirenz
Keith Alcorn, 2012-02-17 10:10:00
New UK draft guidelines on the management of HIV infection in pregnant women recommend that efavirenz-based treatment should no longer be avoided in pregnant women or women who want to have a baby.
Pregnant women were previously recommended to avoid efavirenz treatment, as were women hoping to become pregnant, due to the theoretical risk of birth defects if the foetus was exposed to the drug in the first trimester of pregnancy.
But after rigourous review of the published evidence the British HIV Association guidelines panel concluded: “there are insufficient data to support the former position [of avoiding the drug] and [we] furthermore recommend that efavirenz can be both continued and commenced during pregnancy.”
Women who conceive while taking an efavirenz-containing regimen should continue on it, and women taking any effective HAART regimen should continue on it even if it does not contain AZT (zidovudine), the panel recommends.
World Health Organization guidelines on antiretroviral treatment for the prevention of mother-to-child transmission in resource-constrained settings first recommended the use of efavirenz during pregnancy in 2009, but United States guidelines updated in 2010 recommend avoiding the drug during the first trimester of pregnancy.
The draft guidelines are available for comment until Friday February 24 at the BHIVA website.
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