1. "Real life" use of raltegravir during pregnancy in France: The Coferal-IMEA048 cohort study.
- Author
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Gantner, Pierre, Sylla, Babacar, Morand-Joubert, Laurence, Frange, Pierre, Lacombe, Karine, Khuong, Marie-Aude, Duvivier, Claudine, Launay, Odile, Karmochkine, Marina, Arvieux, Cédric, Ménard, Amélie, Piroth, Lionel, Canestri, Ana, Trias, Dominique, Peytavin, Gilles, Landman, Roland, Ghosn, Jade, and null, null
- Subjects
THIRD trimester of pregnancy ,PREGNANCY ,HEALTH insurance ,HIV infection transmission ,SECOND trimester of pregnancy ,COHORT analysis - Abstract
Introduction: Limited "real life" data on raltegravir (RAL) use during pregnancy are available. Thus, we aimed at describing effectiveness and safety of RAL-based combined antiretroviral therapy (cART) in this setting. Methods: HIV-1-infected women receiving RAL during pregnancy between 2008 and 2014 in ten French centers were retrospectively analysed for: (1) proportion of women receiving RAL anytime during pregnancy who achieved a plasma HIV-RNA (pVL) < 50 copies/mL at delivery, and (2) description of demographics, immuno-virological parameters and safety in women and new-borns. Results: We included 94 women (median age, 33 years) of which 85% originated from Sub-Saharan Africa and 16% did not have regular health insurance coverage. Sixteen women were cART-naïve (median HIV diagnosis at 30 weeks of gestation), whereas 78 were already on cART before pregnancy (40% with pVL < 50 copies/mL). RAL was initiated before pregnancy (n = 33), during the second trimester (n = 11) and the third trimester of pregnancy (n = 50). No RAL discontinuations due to adverse events were observed. Overall, at the time of delivery, pVL was < 50 copies/mL in 70% and < 400 copies/mL in 84% of women. Specifically, pVL at delivery was < 50 copies/mL in 82%, 55% and 56% of cases when RAL was started before pregnancy, during the second or third trimester of pregnancy, respectively. Median term was 38 weeks of gestation, no defect was reported and all new-borns were HIV non-infected at Month 6. Conclusions: RAL appears safe and effective in this "real-life" study. No defect and no HIV transmission was reported in new-borns. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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