The safety of the HIV treatment drug, dolutegravir (DTG), during pregnancy has been one of the most urgent questions in global health for the past year.
At the 22nd International AIDS Conference (AIDS 2018) last year, data from the Tsepamo study in Botswana suggested that the use of DTG in early pregnancy may be linked to neural tube defects (NTDs), serious birth defects of the brain and spine.
As a result, some countries have paused their plans to make DTG-based regimens their preferred first-line therapy and the World Health Organization (WHO) issued a note of caution about the use of DTG by women of childbearing age as part of its interim guidelines recommending DTG as the preferred first- and second-line antiretroviral therapy for people living with HIV.
At the 10th IAS Conference on HIV Science (IAS 2019), additional research from Botswana has found that the risk of NTDs is less than was signalled last year.
To help clinicians and health ministries act on these findings, WHO issued updated recommendations on antiretroviral therapy and DTG use.
To inform these recommendations, a number of community and scientific forums were held to discuss the issue directly with women of reproductive age who have the least access to obtaining DTG.
“Community engagement, including input from women living with HIV, has played a key role in updating these recommendations and will be critical to rolling them out,” Jacque Wambui, African Community Advisory Board (AFROCAB) member, Kenya, said.
“Ultimately, what is most important is offering women the choice to make informed decisions,” Anton Pozniak, International AIDS Society President and IAS 2019 International Scientific Chair, said.
WHO updated these recommendations based on new evidence.