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Rilpivirine in HIV-1-positive women initiating pregnancy : to switch or not to switch? / ANRS EPF CO1/CO11 Study Group ; Camus, Michel.

In: Journal of Antimicrobial Chemotherapy, Vol. 75, No. 5, 2020, p. 1324-1331.

Research output: Contribution to journalArticle

Harvard

ANRS EPF CO1/CO11 Study Group & Camus, M 2020, 'Rilpivirine in HIV-1-positive women initiating pregnancy: to switch or not to switch?', Journal of Antimicrobial Chemotherapy, vol. 75, no. 5, pp. 1324-1331. https://doi.org/10.1093/jac/dkaa017

APA

ANRS EPF CO1/CO11 Study Group , & Camus, M. (2020). Rilpivirine in HIV-1-positive women initiating pregnancy: to switch or not to switch? Journal of Antimicrobial Chemotherapy, 75(5), 1324-1331. https://doi.org/10.1093/jac/dkaa017

Vancouver

ANRS EPF CO1/CO11 Study Group , Camus M. Rilpivirine in HIV-1-positive women initiating pregnancy: to switch or not to switch? Journal of Antimicrobial Chemotherapy. 2020;75(5):1324-1331. https://doi.org/10.1093/jac/dkaa017

Author

ANRS EPF CO1/CO11 Study Group ; Camus, Michel. / Rilpivirine in HIV-1-positive women initiating pregnancy : to switch or not to switch?. In: Journal of Antimicrobial Chemotherapy. 2020 ; Vol. 75, No. 5. pp. 1324-1331.

BibTeX

@article{a82e7da0e3c24a1ba5c4d8c35a2b506f,
title = "Rilpivirine in HIV-1-positive women initiating pregnancy: to switch or not to switch?",
abstract = "BACKGROUND: Safety data about rilpivirine use during pregnancy remain scarce, and rilpivirine plasma concentrations are reduced during second/third trimesters, with a potential risk of viral breakthroughs. Thus, French guidelines recommend switching to rilpivirine-free combinations (RFCs) during pregnancy.OBJECTIVES: To describe the characteristics of women initiating pregnancy while on rilpivirine and to compare the outcomes for virologically suppressed subjects continuing rilpivirine until delivery versus switching to an RFC.METHODS: In the ANRS-EPF French Perinatal cohort, we included women on rilpivirine at conception in 2010-18. Pregnancy outcomes were compared between patients continuing versus interrupting rilpivirine. In women with documented viral suppression (<50 copies/mL) before 14 weeks of gestation (WG) while on rilpivirine, we compared the probability of viral rebound (≥50 copies/mL) during pregnancy between subjects continuing rilpivirine versus those switching to RFC.RESULTS: Among 247 women included, 88.7{\%} had viral suppression at the beginning of pregnancy. Overall, 184 women (74.5{\%}) switched to an RFC (mostly PI/ritonavir-based regimens) at a median gestational age of 8.0 WG. Plasma HIV-1 RNA nearest delivery was <50 copies/mL in 95.6{\%} of women. Among 69 women with documented viral suppression before 14 WG, the risk of viral rebound was higher when switching to RFCs than when continuing rilpivirine (20.0{\%} versus 0.0{\%}, P = 0.046). Delivery outcomes were similar between groups (overall birth defects, 3.8/100 live births; pregnancy losses, 2.0{\%}; preterm deliveries, 10.6{\%}). No HIV transmission occurred.CONCLUSIONS: In virologically suppressed women initiating pregnancy, continuing rilpivirine was associated with better virological outcome than changing regimen. We did not observe a higher risk of adverse pregnancy outcomes.",
keywords = "HIV-1-positive, women, Rilpivirine, Pregnancy, safety, RFC",
author = "{ANRS EPF CO1/CO11 Study Group} and Pierre Frange and Roland Tubiana and Jeanne Sibiude and Ana Canestri and C{\'e}dric Arvieux and C{\'e}cile Brunet-Cartier and Laurent Cotte and Jacques Reynes and Laurent Mandelbrot and Josiane Warszawski and {Le Chenadec}, J{\'e}r{\^o}me and Michel Camus",
note = "{\circledC} The Author(s) 2020. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For permissions, please email: journals.permissions@oup.com.",
year = "2020",
doi = "10.1093/jac/dkaa017",
language = "English",
volume = "75",
pages = "1324--1331",
journal = "Journal of Antimicrobial Chemotherapy",
issn = "0305-7453",
publisher = "Oxford University Press",
number = "5",

}

RIS

TY - JOUR

T1 - Rilpivirine in HIV-1-positive women initiating pregnancy

T2 - to switch or not to switch?

AU - ANRS EPF CO1/CO11 Study Group

AU - Frange, Pierre

AU - Tubiana, Roland

AU - Sibiude, Jeanne

AU - Canestri, Ana

AU - Arvieux, Cédric

AU - Brunet-Cartier, Cécile

AU - Cotte, Laurent

AU - Reynes, Jacques

AU - Mandelbrot, Laurent

AU - Warszawski, Josiane

AU - Le Chenadec, Jérôme

AU - Camus, Michel

N1 - © The Author(s) 2020. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For permissions, please email: journals.permissions@oup.com.

PY - 2020

Y1 - 2020

N2 - BACKGROUND: Safety data about rilpivirine use during pregnancy remain scarce, and rilpivirine plasma concentrations are reduced during second/third trimesters, with a potential risk of viral breakthroughs. Thus, French guidelines recommend switching to rilpivirine-free combinations (RFCs) during pregnancy.OBJECTIVES: To describe the characteristics of women initiating pregnancy while on rilpivirine and to compare the outcomes for virologically suppressed subjects continuing rilpivirine until delivery versus switching to an RFC.METHODS: In the ANRS-EPF French Perinatal cohort, we included women on rilpivirine at conception in 2010-18. Pregnancy outcomes were compared between patients continuing versus interrupting rilpivirine. In women with documented viral suppression (<50 copies/mL) before 14 weeks of gestation (WG) while on rilpivirine, we compared the probability of viral rebound (≥50 copies/mL) during pregnancy between subjects continuing rilpivirine versus those switching to RFC.RESULTS: Among 247 women included, 88.7% had viral suppression at the beginning of pregnancy. Overall, 184 women (74.5%) switched to an RFC (mostly PI/ritonavir-based regimens) at a median gestational age of 8.0 WG. Plasma HIV-1 RNA nearest delivery was <50 copies/mL in 95.6% of women. Among 69 women with documented viral suppression before 14 WG, the risk of viral rebound was higher when switching to RFCs than when continuing rilpivirine (20.0% versus 0.0%, P = 0.046). Delivery outcomes were similar between groups (overall birth defects, 3.8/100 live births; pregnancy losses, 2.0%; preterm deliveries, 10.6%). No HIV transmission occurred.CONCLUSIONS: In virologically suppressed women initiating pregnancy, continuing rilpivirine was associated with better virological outcome than changing regimen. We did not observe a higher risk of adverse pregnancy outcomes.

AB - BACKGROUND: Safety data about rilpivirine use during pregnancy remain scarce, and rilpivirine plasma concentrations are reduced during second/third trimesters, with a potential risk of viral breakthroughs. Thus, French guidelines recommend switching to rilpivirine-free combinations (RFCs) during pregnancy.OBJECTIVES: To describe the characteristics of women initiating pregnancy while on rilpivirine and to compare the outcomes for virologically suppressed subjects continuing rilpivirine until delivery versus switching to an RFC.METHODS: In the ANRS-EPF French Perinatal cohort, we included women on rilpivirine at conception in 2010-18. Pregnancy outcomes were compared between patients continuing versus interrupting rilpivirine. In women with documented viral suppression (<50 copies/mL) before 14 weeks of gestation (WG) while on rilpivirine, we compared the probability of viral rebound (≥50 copies/mL) during pregnancy between subjects continuing rilpivirine versus those switching to RFC.RESULTS: Among 247 women included, 88.7% had viral suppression at the beginning of pregnancy. Overall, 184 women (74.5%) switched to an RFC (mostly PI/ritonavir-based regimens) at a median gestational age of 8.0 WG. Plasma HIV-1 RNA nearest delivery was <50 copies/mL in 95.6% of women. Among 69 women with documented viral suppression before 14 WG, the risk of viral rebound was higher when switching to RFCs than when continuing rilpivirine (20.0% versus 0.0%, P = 0.046). Delivery outcomes were similar between groups (overall birth defects, 3.8/100 live births; pregnancy losses, 2.0%; preterm deliveries, 10.6%). No HIV transmission occurred.CONCLUSIONS: In virologically suppressed women initiating pregnancy, continuing rilpivirine was associated with better virological outcome than changing regimen. We did not observe a higher risk of adverse pregnancy outcomes.

KW - HIV-1-positive

KW - women

KW - Rilpivirine

KW - Pregnancy

KW - safety

KW - RFC

U2 - 10.1093/jac/dkaa017

DO - 10.1093/jac/dkaa017

M3 - Article

C2 - 32157283

VL - 75

SP - 1324

EP - 1331

JO - Journal of Antimicrobial Chemotherapy

JF - Journal of Antimicrobial Chemotherapy

SN - 0305-7453

IS - 5

ER -

ID: 51775393