A systematic review and meta-analysis of maternal weight changes and pregnancy outcomes associated with integrase inhibitors and tenofovir alafenamide in pregnant women with HIV

OBJECTIVE: The global epidemiology of HIV during pregnancy highlights the challenges faced by women living with HIV worldwide. In 2022, more than 1.3 million pregnant women were living with HIV globally, with approximately 77% of all new diagnoses occurring in sub-Saharan Africa, marking a considerable burden. Antiretroviral therapy (ART) that is recommended during pregnancy involves a 3-drug regimen: 2 nucleoside reversetranscriptase inhibitors (NRTIs) combined with 1 ART from a different class, categorized as either “preferred or recommended” or “alternative.” Preferred NRTIs include tenofovir alafenamide (TAF) and tenofovir disoproxil fumarate (TDF), which are key components when combined with integrase
strand inhibitors (INSTIs) in regimens, such as dolutegravir (DTG)/TAF/emtricitabine (FTC), bictegravir/TAF/FTC, and raltegravir/TAF/FTC. In addition, several non−INSTI-based ART regimens are used in pregnancy. Uncertainties persist regarding which ART regimen offers the best safety and
adverse effect profile. This systematic review and meta-analysis examined the effects of INSTI-/TAF-based regimens on maternal weight and pregnancy outcomes in pregnant women with HIV compared with
those of non−INSTI-/non−TAF-based ART regimens.

• Population(s)
  • Women
  • General HIV+ population
• Prevention, Engagement and Care Cascade
  • Engagement and Care Cascade
• Engagement and Care Cascade
  • Treatment
• Co-morbidities
  • Other