Women randomized to continued antiretroviral therapy (ART) who subsequently conceived were more likely to have spontaneous abortion or stillbirth compared to women randomized to stop ART, a new study found. Asymptomatic HIV-infected, non-breastfeeding women with pre-ART CD4 counts ≥400 cells/mm3 who started ART during pregnancy were randomized after delivery to continue (cART) or discontinue ART (dART). Women randomized to dART were recommended to restart if a subsequent pregnancy occurred or for clinical indications. Researchers found:
- Subsequent pregnancies occurred in 277/1,652 (17%) women (cART: 144/827, dART: 133/825).
- A pregnancy outcome was recorded for 266 (96%) women with median age 27 years and median CD4+ T-cell count 638 cells/mm3.
- When spontaneous abortions and stillbirths were combined, there was a significant difference in events, with 33/140 (23.6%) in the cART arm and 15/126 (11.9%) in the dART arm.
Hoffman RM, Brummel SS, Britto P, et al. Adverse pregnancy outcomes among women who conceive on antiretroviral therapy. [Published online ahead of print June 1, 2018]. Clin Infect Dis. doi:10.1093/cid/ciy471.
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