Dolutegravir-Based Antiretroviral Therapy Is the Regimen of Choice During Pregnancy

Dolutegravir-based antiretroviral therapy (ART) during pregnancy has been associated with better viral suppression at delivery compared with efavirenz-based ART. But what about the safety and efficacy of dolutegravir-based ART compared with other regimens considered as “preferred” in the U.S. perinatal guidelines (such as those with raltegravir, atazanavir-ritonavir, and darunavir-ritonavir)? As part of a large cohort study, investigators evaluated viral suppression at delivery and adverse birth outcomes in pregnant persons with HIV on ART in the U.S. and Europe.

A total of 1257 participants had an observed birth outcome (66% non-Hispanic Black; median age, 29). In 51%, ART had been initiated prior to conception. ART regimens included those …