Connect with us

Hi, what are you looking for?

POZ

Pregnant women with HIV often not given recommended treatment

A study involving more than 1,500 women found that 30% were prescribed drugs that had insufficient evidence of safety in pregnancy.

Photo by Ashton Mullins from Unsplash.com

Women living with HIV who are also pregnant don’t always receive recommended antiretroviral medications, according to a recent study of prescribing patterns carried out by a MassGeneral Hospital for Children (MGHfC) researcher in collaboration with other members of the Surveillance Monitoring for ART Toxicities (SMARTT) study of the Pediatric HIV/AIDS Cohort Study (PHACS) network.

Few studies, if any, have compared actual prescribing patterns of HIV medications for pregnant women to national treatment guidelines. This study suggests that physicians may be prescribing ahead of the published recommendations, and using drugs or drug combinations they have seen work in the adult population in general.

“We studied, more than 1,500 women and found that 30% were prescribed drugs that had insufficient evidence of safety in pregnancy,” says Kathleen M. Powis, MD, MPH, investigator in MGHfC’s division of Pediatric Global Health and first author of the study, which was published in JAMA Network Open.

For the last 25 years, the US Department of Health and Human services Panel on Treatment of HIV-infected Pregnant Women and Prevention of Perinatal Transmission has published Perinatal HIV Treatment Guidelines on prescribing antiretroviral medications (ARVs) during pregnancy. In 1994, the guidelines just addressed the use of zidovudine, then the only drug approved to treat HIV infection. But by 2008 the prescribing guidelines for pregnant women were updated to recommend the use of triple ARVs, regardless of the woman’s HIV disease status. Pregnant women are typically excluded from studies testing newer drugs until safety has been established in nonpregnant adults. As a result, this data is usually some of the last to be collected.

“The guidelines change nearly annually,” says Powis, who is also an assistant professor of Pediatrics at Harvard Medical School (HMS). “And a lot of the treatments that doctors are already using simply had ‘insufficient data’ to recommend their use in pregnant women. But doctors were prescribing them anyway.”

Since many of these regimens (70%) were eventually recommended for pregnant women, Powis suggests that doctors may be prescribing “ahead of time.” That is, they are seeing promising therapeutic results in the general population, and prescribing HIV drug treatment combinations to pregnant women based on that experience, rather than on guidelines.

Advertisement
Advertisement

Like Us On Facebook

YOU MAY ALSO LIKE

POZ

The amount allocated for every Filipino living with HIV under the Outpatient HIV/AIDS Treatment (OHAT) Package of the Philippine Health Insurance Corporation (PhilHealth) has...

POZ

Women with HIV experience accelerated DNA aging, a phenomenon that can lead to poor physical function.

From the Editor

May mga yumayaman sa HIV “advocacy”. And this is maddening because this often comes at the expense of PLHIVs themselves. So we say, enough....

From the Editor

Yes, seminars are essential in LGBTQIA and HIV advocacy. But for some, it's the be-all/end-all of all efforts, giving rise to 'seminar activists' who...

Advertisement