{"id":32937,"date":"2017-11-28T12:13:05","date_gmt":"2017-11-28T12:13:05","guid":{"rendered":"http:\/\/i-base.info\/htb\/?p=32937"},"modified":"2017-11-28T16:54:54","modified_gmt":"2017-11-28T16:54:54","slug":"raltegravir-during-pregnancy-reassuring-french-data","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/32937","title":{"rendered":"Reassuring French data using raltegravir during pregnancy"},"content":{"rendered":"

Polly Clayden, HIV i-Base<\/strong><\/p>\n

\"\"A presentation from the French Perinatal Cohort at IAS 2017 reported reassuring safety data on raltegravir-exposed pregnancies – including first trimester exposure. [1]<\/strong><\/p>\n

This large prospective cohort of children exposed to raltegravir (RAL) in utero found no significant association between first\u00a0trimester exposure and birth defects.<\/p>\n

There is currently no published literature on RAL and birth defects. The largest report is from the Antiretroviral Pregnancy Registry (APR) to January 2017. The APR reports 7 birth defects out of 263 first trimester exposures (2.7%) and no difference with second\/third trimester exposure (8\/250, 3.2%). [2]<\/p>\n

The French Perinatal Cohort (EPF) is a multicentre ongoing, prospective, national cohort, which enrols pregnant HIV positive women delivering in 90 centres throughout France. Children are then followed until they are two years old.<\/p>\n

The EPF evaluation included all RAL-exposed pregnancies between 2008 and 2015. Birth defects were defined using the EUROCAT classification.<\/p>\n

There were 479 RAL-exposed pregnancies of which 6 (1.3%) resulted in stillbirths and 2 late miscarriages (0.4%). There were 68 (14.2%) preterm deliveries and 10 (2.1%) twin pregnancies. No pregnancies were terminated for birth defects.<\/p>\n

Earliest RAL-exposure was in the first trimester for 140 (29.2%) and second\/third trimester for 339 (78.8%).<\/p>\n

There were 20\/479 birth defects for all births: 4.2% (95% CI: 2.4 to 6.0%). And 20\/471 among live births: 4.2% (95% CI: 2.4% to 6.1%). The investigators noted that this incidence was similar to that reported in a previous study in EPF for live births exposed to any antiretroviral: 4.4% (95% CI: 4.0 to 4.7%).<\/p>\n

The was no significant difference in overall birth defect rates between first trimester and second\/third trimester exposure to raltegravir: 5.7% vs 3.5%; OR 1.6 (95% CI: 0.7 to 4.1), p=0.29.<\/p>\n

The anomalies did not follow a pattern: 7 heart defects, 5 polydactyly, and 8 other defects.<\/p>\n

Follow-up was complete to 24 months for 63% of children at time of analysis.<\/p>\n

References:<\/p>\n

    \n
  1. Sibiude J et al. Evaluation of the risk of birth defects among children exposed to raltegravir\u00a0in utero\u00a0in the ANRS-French Perinatal Cohort EPF. IAS 2017. 23-26 July 2017. Paris. MOAB0204,
    \nhttp:\/\/programme.ias2017.org\/Abstract\/Abstract\/3037<\/a><\/li>\n
  2. Antiretroviral Pregnancy Registry (APR) international interim report. 1 January 1989 to 31 January 2017.
    \n    http:\/\/www.apregistry.com\/forms\/interim_report.pdf<\/a> (PDF)<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

    Polly Clayden, HIV i-Base A presentation from the French Perinatal Cohort at IAS 2017 reported reassuring safety data on raltegravir-exposed pregnancies – including first trimester exposure. [1] This large prospective cohort of children exposed to raltegravir (RAL) in utero found …<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4,35],"tags":[243],"class_list":["post-32937","post","type-post","status-publish","format-standard","hentry","category-conference-reports","category-pmtct-and-maternal-health","tag-ias-9-paris-2017"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/32937","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=32937"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/32937\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=32937"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=32937"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=32937"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}