Anti-HIV drug combination does not increase preterm birth risk, study suggests

NIH-funded study could allay concerns about regimens containing TDF

In a news release published on April 25, 2018, the National Institutes of Health (NIH) announced findings from a re-analysis of two studies funded by the NIH.

A drug combination aimed at preventing transmission of HIV from a pregnant woman to her fetus likely does not increase the risk for preterm birth and early infant death, according to the re-analysis. The research appears in the New England Journal of Medicine. A co-author on the study is Ellen Chadwick, MD (shown at left), Co-Medical Director of Pediatric and Maternal HIV Infection and an attending physician in the Division of Infectious Diseases at Lurie Children's. Chadwick is also Irene Heinz Given and John LaPorte Given Chair in Pediatrics and Professor of Pediatrics at Northwestern University Feinberg School of Medicine.

A previous study, called PROMISE or Promoting Maternal and Infant Survival Everywhere, compared the effectiveness of several drugs and treatment regimens prescribed to pregnant women with HIV in India and six African countries. It found that, compared to women on zidovudine-based therapy, women taking a combination treatment including the drug tenofovir disoproxil fumarate (TDF) were twice as likely to give birth to a very preterm infant and their infants were more likely to die within the first 14 days of life.

The authors of the current study wrote that the PROMISE results were surprising, given that earlier studies had found combinations containing TDF to be safe for use during pregnancy. The World Health Organization recommends that all adults with HIV, including pregnant women, receive a combination therapy that includes TDF.

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