A multicenter analysis of elvitegravir use during pregnancy on HIV viral suppression and perinatal outcomes

Martina L. Badell*, Anandi N. Sheth, Florence Momplaisir, Lisa Rahangdale, Jo Nell Potter, Padmashree C. Woodham, Gweneth B. Lazenby, William R. Short, Scott E. Gillespie, Nevert Baldreldin, Emily S. Miller, Gregg Alleyne, Lunthita M. Duthely, Stephanie M. Allen, Judy Levison, Rana Chakraborty

*Corresponding author for this work

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background. There is a knowledge gap on the clinical use of elvitegravir (EVG) during pregnancy and maternal viral suppression. Our objective was to evaluate the effects of EVG use in pregnancy on rates of HIV virologic suppression and perinatal outcomes. Methods. We conducted a retrospective, multicenter study of pregnant women living with HIV (WLHIV) who used EVGcontaining antiretroviral therapy (ART) between January 2014 and March 2017 at 9 tertiary care centers in the United States. WLHIV were included if they took EVG at any time during pregnancy. We described the characteristics of the WLHIV using EVG during the study period and evaluated the rates of HIV suppression and perinatal outcomes. Results. Among 134 pregnant WLHIV who received EVG at any time during pregnancy, viral suppression at delivery (HIV-1 RNA < 40 copies/mL) occurred in 81.3%. In WLHIV who initiated EVG before pregnancy and continued through delivery (n = 68), the rate of viral suppression at delivery was 88.2%. The average gestational age at the time of delivery was 37 weeks 6 days, and the overall rate of preterm birth was 20%. No cases of open neural tube defects were noted in women on EVG at the time of conception (n = 82). The perinatal HIV transmission rate was 0.8%. Conclusions. EVG use was associated with high sustained levels of HIV suppression during pregnancy and a low rate of perinatal HIV transmission.

Original languageEnglish (US)
JournalOpen Forum Infectious Diseases
Volume6
Issue number4
DOIs
StatePublished - Apr 2019

Fingerprint

HIV
Pregnancy
Pregnant Women
JTK 303
Neural Tube Defects
Premature Birth
Pregnancy Rate
Tertiary Care Centers
Gestational Age
Multicenter Studies
HIV-1
Retrospective Studies
Mothers
RNA

Keywords

  • HIV viral suppression
  • Obstetrics and gynecology
  • Perinatal outcomes
  • Prevention of mother-to-child transmission

ASJC Scopus subject areas

  • Oncology
  • Clinical Neurology

Cite this

Badell, M. L., Sheth, A. N., Momplaisir, F., Rahangdale, L., Potter, J. N., Woodham, P. C., ... Chakraborty, R. (2019). A multicenter analysis of elvitegravir use during pregnancy on HIV viral suppression and perinatal outcomes. Open Forum Infectious Diseases, 6(4). https://doi.org/10.1093/ofid/ofz129
Badell, Martina L. ; Sheth, Anandi N. ; Momplaisir, Florence ; Rahangdale, Lisa ; Potter, Jo Nell ; Woodham, Padmashree C. ; Lazenby, Gweneth B. ; Short, William R. ; Gillespie, Scott E. ; Baldreldin, Nevert ; Miller, Emily S. ; Alleyne, Gregg ; Duthely, Lunthita M. ; Allen, Stephanie M. ; Levison, Judy ; Chakraborty, Rana. / A multicenter analysis of elvitegravir use during pregnancy on HIV viral suppression and perinatal outcomes. In: Open Forum Infectious Diseases. 2019 ; Vol. 6, No. 4.
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title = "A multicenter analysis of elvitegravir use during pregnancy on HIV viral suppression and perinatal outcomes",
abstract = "Background. There is a knowledge gap on the clinical use of elvitegravir (EVG) during pregnancy and maternal viral suppression. Our objective was to evaluate the effects of EVG use in pregnancy on rates of HIV virologic suppression and perinatal outcomes. Methods. We conducted a retrospective, multicenter study of pregnant women living with HIV (WLHIV) who used EVGcontaining antiretroviral therapy (ART) between January 2014 and March 2017 at 9 tertiary care centers in the United States. WLHIV were included if they took EVG at any time during pregnancy. We described the characteristics of the WLHIV using EVG during the study period and evaluated the rates of HIV suppression and perinatal outcomes. Results. Among 134 pregnant WLHIV who received EVG at any time during pregnancy, viral suppression at delivery (HIV-1 RNA < 40 copies/mL) occurred in 81.3{\%}. In WLHIV who initiated EVG before pregnancy and continued through delivery (n = 68), the rate of viral suppression at delivery was 88.2{\%}. The average gestational age at the time of delivery was 37 weeks 6 days, and the overall rate of preterm birth was 20{\%}. No cases of open neural tube defects were noted in women on EVG at the time of conception (n = 82). The perinatal HIV transmission rate was 0.8{\%}. Conclusions. EVG use was associated with high sustained levels of HIV suppression during pregnancy and a low rate of perinatal HIV transmission.",
keywords = "HIV viral suppression, Obstetrics and gynecology, Perinatal outcomes, Prevention of mother-to-child transmission",
author = "Badell, {Martina L.} and Sheth, {Anandi N.} and Florence Momplaisir and Lisa Rahangdale and Potter, {Jo Nell} and Woodham, {Padmashree C.} and Lazenby, {Gweneth B.} and Short, {William R.} and Gillespie, {Scott E.} and Nevert Baldreldin and Miller, {Emily S.} and Gregg Alleyne and Duthely, {Lunthita M.} and Allen, {Stephanie M.} and Judy Levison and Rana Chakraborty",
year = "2019",
month = "4",
doi = "10.1093/ofid/ofz129",
language = "English (US)",
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journal = "Open Forum Infectious Diseases",
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Badell, ML, Sheth, AN, Momplaisir, F, Rahangdale, L, Potter, JN, Woodham, PC, Lazenby, GB, Short, WR, Gillespie, SE, Baldreldin, N, Miller, ES, Alleyne, G, Duthely, LM, Allen, SM, Levison, J & Chakraborty, R 2019, 'A multicenter analysis of elvitegravir use during pregnancy on HIV viral suppression and perinatal outcomes', Open Forum Infectious Diseases, vol. 6, no. 4. https://doi.org/10.1093/ofid/ofz129

A multicenter analysis of elvitegravir use during pregnancy on HIV viral suppression and perinatal outcomes. / Badell, Martina L.; Sheth, Anandi N.; Momplaisir, Florence; Rahangdale, Lisa; Potter, Jo Nell; Woodham, Padmashree C.; Lazenby, Gweneth B.; Short, William R.; Gillespie, Scott E.; Baldreldin, Nevert; Miller, Emily S.; Alleyne, Gregg; Duthely, Lunthita M.; Allen, Stephanie M.; Levison, Judy; Chakraborty, Rana.

In: Open Forum Infectious Diseases, Vol. 6, No. 4, 04.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - A multicenter analysis of elvitegravir use during pregnancy on HIV viral suppression and perinatal outcomes

AU - Badell, Martina L.

AU - Sheth, Anandi N.

AU - Momplaisir, Florence

AU - Rahangdale, Lisa

AU - Potter, Jo Nell

AU - Woodham, Padmashree C.

AU - Lazenby, Gweneth B.

AU - Short, William R.

AU - Gillespie, Scott E.

AU - Baldreldin, Nevert

AU - Miller, Emily S.

AU - Alleyne, Gregg

AU - Duthely, Lunthita M.

AU - Allen, Stephanie M.

AU - Levison, Judy

AU - Chakraborty, Rana

PY - 2019/4

Y1 - 2019/4

N2 - Background. There is a knowledge gap on the clinical use of elvitegravir (EVG) during pregnancy and maternal viral suppression. Our objective was to evaluate the effects of EVG use in pregnancy on rates of HIV virologic suppression and perinatal outcomes. Methods. We conducted a retrospective, multicenter study of pregnant women living with HIV (WLHIV) who used EVGcontaining antiretroviral therapy (ART) between January 2014 and March 2017 at 9 tertiary care centers in the United States. WLHIV were included if they took EVG at any time during pregnancy. We described the characteristics of the WLHIV using EVG during the study period and evaluated the rates of HIV suppression and perinatal outcomes. Results. Among 134 pregnant WLHIV who received EVG at any time during pregnancy, viral suppression at delivery (HIV-1 RNA < 40 copies/mL) occurred in 81.3%. In WLHIV who initiated EVG before pregnancy and continued through delivery (n = 68), the rate of viral suppression at delivery was 88.2%. The average gestational age at the time of delivery was 37 weeks 6 days, and the overall rate of preterm birth was 20%. No cases of open neural tube defects were noted in women on EVG at the time of conception (n = 82). The perinatal HIV transmission rate was 0.8%. Conclusions. EVG use was associated with high sustained levels of HIV suppression during pregnancy and a low rate of perinatal HIV transmission.

AB - Background. There is a knowledge gap on the clinical use of elvitegravir (EVG) during pregnancy and maternal viral suppression. Our objective was to evaluate the effects of EVG use in pregnancy on rates of HIV virologic suppression and perinatal outcomes. Methods. We conducted a retrospective, multicenter study of pregnant women living with HIV (WLHIV) who used EVGcontaining antiretroviral therapy (ART) between January 2014 and March 2017 at 9 tertiary care centers in the United States. WLHIV were included if they took EVG at any time during pregnancy. We described the characteristics of the WLHIV using EVG during the study period and evaluated the rates of HIV suppression and perinatal outcomes. Results. Among 134 pregnant WLHIV who received EVG at any time during pregnancy, viral suppression at delivery (HIV-1 RNA < 40 copies/mL) occurred in 81.3%. In WLHIV who initiated EVG before pregnancy and continued through delivery (n = 68), the rate of viral suppression at delivery was 88.2%. The average gestational age at the time of delivery was 37 weeks 6 days, and the overall rate of preterm birth was 20%. No cases of open neural tube defects were noted in women on EVG at the time of conception (n = 82). The perinatal HIV transmission rate was 0.8%. Conclusions. EVG use was associated with high sustained levels of HIV suppression during pregnancy and a low rate of perinatal HIV transmission.

KW - HIV viral suppression

KW - Obstetrics and gynecology

KW - Perinatal outcomes

KW - Prevention of mother-to-child transmission

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U2 - 10.1093/ofid/ofz129

DO - 10.1093/ofid/ofz129

M3 - Article

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VL - 6

JO - Open Forum Infectious Diseases

JF - Open Forum Infectious Diseases

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