Rough K, et al. - Researchers undertook a comparison of the risk of adverse birth outcomes among infants with in utero exposure to zidovudine, lamivudine, and ritonavir-boosted lopinavir (ZDV–3TC–LPV/r), tenofovir, emtricitabine, and ritonavir-boosted lopinavir (TDF–FTC–LPV/r), or TDF–FTC with ritonavir-boosted atazanavir (ATV/r). Findings illustrated that the risk of adverse birth outcomes was not higher with TDF–FTC–LPV/r compared to ZDV–3TC–LPV/r or TDF–FTC–ATV/r among HIV-infected women and their infants in the United States. However, power was limited for some comparisons.

Methods

• The risk of preterm birth (<37 completed weeks of gestation), very preterm birth (<34 completed weeks), low birth weight (<2500 g), and very low birth weight (<1500 g) was determined.
• Using modified Poisson models, the risk ratios with 95% confidence intervals were estimated to adjust for confounding.

Results

• A total of 4,646 birth outcomes were reported.
• It was disclosed that few infants or fetuses were exposed to TDF-FTC-LPV/r (128 [2.8%]) as the initial ART regimen during gestation vs TDF-FTC-ATV/r (539 [11.6%]) and ZDV-3TC-LPV/r (954 [20.5%]).
• In contrast with women receiving ZDV-3TC-LPV/r, women receiving TDF-FTC-LPV/r demonstrated a similar risk of preterm birth (risk ratio, 0.90; 95% confidence interval [CI], 0.60 to 1.33) and low birth weight (risk ratio, 1.13; 95% CI, 0.78 to 1.64).
• In comparison with women receiving TDF-FTC-ATV/r, women receiving TDF-FTC-LPV/r illustrated a similar or slightly higher risk of preterm birth (risk ratio, 1.14; 95% CI, 0.75 to 1.72) and low birth weight (risk ratio, 1.45; 95% CI, 0.96 to 2.17).
• No notable variations were detected between regimens in the risk of very preterm birth or very low birth weight.