Dolutegravir-Based ART May Be Best Option for Reproductive-Age Women in High-Burden Countries

In May 2018, preliminary results of the Tsepamo study suggested an association of dolutegravir (DTG) with neural tube defects (NTD) that was not seen with efavirenz (EFV), shocking the global health community as tenofovir-dolutegravir-lamivudine (TDL) was planned for roll-out as a relative safe, effective, tolerable, and inexpensive regimen. Therefore, the World Health Organization recommended EFV as a safer regimen for women of childbearing potential who wish to become pregnant or who have no access to contraception. To examine the clinical implications of using DTG versus EFV among women of childbearing potential in South Africa, investigators conducted a model-based analysis comparing three strategies: initiation or continuation of EFV, …