Pre-exposure prophylaxis for infants exposed to HIV through breast feeding

Perre, Philippe Van de; Kankasa, Chipepo; Nagot, Nicolas; Méda, Nicolas; Tumwine, James K; Coutsoudis, Anna; Tylleskär, Thorkild; Coovadia, Hoosen

doi:10.1136/bmj.j1053

Cited by 12 publications

(14 citation statements)

References 11 publications

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“…As lifelong maternal cART is now the WHO recommendation, these infant PrEP regimens are less likely to be used on a large scale. There are no clinical trials of maternal cART plus infant PrEP in the context of breastfeeding, although it has been suggested that this could be a feasible approach in resource‐poor settings where women may not have fully suppressed viral load and may be more likely to give medication to the infant than take it themselves .…”

Section: Neonatal Managementmentioning

confidence: 99%

British HIV Association guidelines for the management of HIV in pregnancy and postpartum 2018

et al. 2019

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Section: Neonatal Managementmentioning

confidence: 99%

British HIV Association guidelines for the management of HIV in pregnancy and postpartum 2018

et al. 2019

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“…2-4 Thus, evaluation of the safety and efficacy of alternative strategies, such as infant prophylaxis, to reduce postnatal infection remains important. 5…”

Section: Introductionmentioning

confidence: 99%

Prevention of HIV-1 Transmission Through Breastfeeding: Efficacy and Safety of Maternal Antiretroviral Therapy Versus Infant Nevirapine Prophylaxis for Duration of Breastfeeding in HIV-1-Infected Women With High CD4 Cell Count (IMPAACT PROMISE): A Randomized, Open-Label, Clinical Trial

Flynn

Taha

Cababasay

et al. 2018

JAIDS Journal of Acquired Immune Deficiency Syndromes

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147

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“…Multiple studies have demonstrated that ARVs to the mother (and/or infant) throughout the entire period of VT risk (pregnancy, delivery and the duration of breast feeding) are critical to prevent new infant infections [7, 8**, 9–11]. The Promoting Maternal and Infant Survival Everywhere (PROMISE) trial recently finally provided randomised trial evidence for the beneficial effect on early VT of maternal ART initiated during pregnancy compared to zidovudine (ZDV) prophylaxis in women with high CD4 counts [12**].…”

Section: Importance Of a Maximally Suppressive Regimen For Maternal Hmentioning

confidence: 99%

Toward a universal antiretroviral regimen

Slogrove

Clayden²,

Abrams

2017

Current Opinion in HIV and AIDS

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Purpose of review As optimized antiretroviral therapy (ART) regimens are prepared for introduction in low and middle income countries (LMIC), we consider the current evidence related to dosing, efficacy and safety during pregnancy and breastfeeding of next generation first- and second-line ART regimens proposed for imminent introduction in the global marketplace. Recent findings Pregnancy pharmacokinetic considerations include potentially insufficient efavirenz exposure if dosed at 400mg/day, the need for twice daily darunavir dosing and the paucity of data related to tenofovir alafenamide and dolutegravir dosing, safety and efficacy. Increasingly evidence suggests an association with adverse birth outcomes, particularly in women conceiving on ART, and with varying risk by drug and drug combination. Clinical trials and studies are in progress or planned that aim to determine dosing, safety and efficacy of several new antiretrovirals. Summary Having a universal, highly potent and safe ART regimen for all individuals living with HIV in LMIC including pregnant women is clearly the most beneficial strategy to keep mothers alive and healthy and to prevent transmission of HIV to their children. It will have to be determined whether use of this next generation of optimized antiretrovirals will also optimize health outcomes of pregnant women and their children.

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Pre-exposure prophylaxis for infants exposed to HIV through breast feeding

Abstract: International audience

Cited by 12 publications

References 11 publications

British HIV Association guidelines for the management of HIV in pregnancy and postpartum 2018

British HIV Association guidelines for the management of HIV in pregnancy and postpartum 2018

Prevention of HIV-1 Transmission Through Breastfeeding: Efficacy and Safety of Maternal Antiretroviral Therapy Versus Infant Nevirapine Prophylaxis for Duration of Breastfeeding in HIV-1-Infected Women With High CD4 Cell Count (IMPAACT PROMISE): A Randomized, Open-Label, Clinical Trial

Toward a universal antiretroviral regimen

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