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Current guidelines from the U.S. Department of Health and Human Services recommend that pregnant HIV-infected women receive lopinavir/ritonavir-based antiretroviral therapy (ART) to prevent mother-to-child transmission of the virus. However, some observational studies, most of which were in Europe, have suggested that protease inhibitor (PI)-based therapy is associated with premature delivery. At CROI 2011, we saw perhaps the strongest evidence yet to support this association.
In a clinical trial conducted in Botswana, 530 pregnant HIV-infected women were randomized to receive AZT/3TC plus either abacavir or lopinavir/r. Rates of mother-to-child transmission were extremely low in both groups, as reported previously (N Engl J Med 2010; 362:22…