The World Health Organisation has issued an updated recommendation on the use of antiretroviral therapy by pregnant women, stating that the risk of neural tube defects was minimal using dolutegravir.

 

The safety of the HIV treatment drug, dolutegravir (DTG), during pregnancy, has been one of the most urgent questions in global health in the past year. At the 22nd International AIDS Conference in 2018, 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.

This led to some countries pausing their plans to make DTG-based regimens their preferred first-line therapy and the 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 in July 2019, additional research from Botswana, however, found that the risk of NTDs is less than was signaled last year. To help clinicians and health ministries to act on the findings, WHO has issued updated recommendations on antiretroviral therapy and DTG use.

 

African Community Advisory Board member, Kenya, Dr Jacque Wambui, said, “Community engagement, including input from women living with HIV, has played a key role in updating these recommendations.” Also, President, International AIDS Society, Dr Anton Pozniak, said the updated recommendations will help women in making informed decisions.