Taking anti-HIV medication did not result in significant differences in pregnancies, birth outcomes and infant growth among heterosexual African couples where the male was HIV-positive and the female was not, according to researchers at the University of Washington School of Public Health. However, the researchers noted the results don’t provide a definitive conclusion about the safety of antiretroviral pre-exposure preventive (PrEP) therapy taken around the time of pregnancy.
PrEP is a pill containing medicine shown to be effective in treating HIV, and it could be an important part of safer conception strategies for women at risk of HIV. The study, led by Dr. Nelly Mugo of the Kenya Medical Research Institute and the University of Washington Department of Global health, was published in the Journal of the American Medical Association. It was a follow-up to the Partners PrEP Study, a large clinical trial in Kenya and Uganda of nearly 5,000 couples led by Drs. Jared Baeten and Connie Celum, professors of Global Health at the University of Washington and co-authors of the current study. The Partners PrEP Study showed that pre-exposure prophylaxis can significantly reduce the risk of HIV infection among those most at risk of acquiring it.
For this analysis, which included 1,785 couples, a total of 431 pregnancies occurred during the study period. Researchers found there was no statistically significant association between women receiving PrEP and those receiving placebo and pregnancy loss. Occurrence of preterm birth, congenital anomalies, kidney function, and growth throughout the first year of life did not differ significantly for infants born to women who received PrEP versus placebo. Given that PrEP was discontinued when pregnancy was detected and confidence intervals for the study were wide, the authors wrote: “These results should be discussed with HIV-uninfected women receiving PrEP who are considering becoming pregnant.”