Dolutegravir Use Among HIV-Positive Women of Reproductive Age in Low- and Middle-Income Countries

Dolutegravir is among the preferred first- and second-line antiretroviral regimens for adults and teens with HIV, but after an interim analysis in 2018 of the Tsepamo cohort raised a potential concern about dolutegravir exposure during pregnancy and infant neural tube defects, WHO cautioned against dolutegravir use among women of reproductive age — and many countries restricted access. Based on additional data in 2019 (NEJM JW Womens Health Sep 2019; multiple citations), WHO revised this guidance to recommend dolutegravir-containing ART for all adults and adolescents with HIV. Has global use evolved accordingly?

Investigators used the IeDEA database to describe uptake and disparities in dolutegravir use by sex and age among 134,672 persons (…