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Pediatric Drugs
Published in: Pediatric Drugs 3/2023

02-02-2023 | Pharmacokinetics | Review Article

Antiretroviral Options and Treatment Decisions During Pregnancy

Authors: Natalie E. Poliektov, Martina L. Badell

Published in: Pediatric Drugs | Issue 3/2023

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Abstract

The majority of pediatric human immunodeficiency virus (HIV) infections are the result of vertical transmissions that occur during pregnancy, childbirth, and breastfeeding. The treatment of all pregnant persons living with HIV remains a global health initiative. Early and consistent use of antiretroviral therapy throughout pregnancy and childbirth drastically reduces the risk of perinatal transmission of HIV, resulting in fewer children living with the disease worldwide. Given that the maternal HIV viral load is the strongest predictor of perinatal transmission, suppressive antiretroviral treatment during pregnancy is the principal means to eliminate transmission of HIV from mother to child. With the use of combined antiretroviral therapy, typically with dual-nucleoside reverse transcriptase inhibitors plus an integrase strand transfer inhibitor or a ritonavir-boosted protease inhibitor, HIV-infected mothers can now achieve virologic suppression to undetectable levels and yield a perinatal transmission rate of less than 2%. Important considerations of HIV treatment in pregnancy include the safety and efficacy of antiretroviral drugs, altered pregnancy-related pharmacokinetics, potential for birth defects or adverse neonatal outcomes, and individualized delivery planning based on maternal viral load. This practical review article summarizes the options, considerations, and recommendations for antiretroviral treatment in pregnancy to reduce perinatal HIV transmission and optimize health outcomes for mothers and infants worldwide.
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Metadata
Title
Antiretroviral Options and Treatment Decisions During Pregnancy
Authors
Natalie E. Poliektov
Martina L. Badell
Publication date
02-02-2023
Publisher
Springer International Publishing
Published in
Pediatric Drugs / Issue 3/2023
Print ISSN: 1174-5878
Electronic ISSN: 1179-2019
DOI
https://doi.org/10.1007/s40272-023-00559-w

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