CROI 2019—Prenatal exposure to InSTI not tied to neural tube defects


  • Jim Kling
  • Conference Reports
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • Researchers found no association between prenatal exposure to integrase inhibitors (InSTIs) and risk for neural tube defects.

Why this matters

  • A previous study raised concerns that dolutegravir could be associated with neural tube defects.

Study design

  • Retrospective analysis of data from the French Perinatal Cohort (309 infants).
  • 3 groups: G1, ongoing exposure at conception; G2, exposure initiated during pregnancy, first-line therapy; and G3, exposure initiated during pregnancy, second-line therapy.
  • Women who received InSTIs but not a protease inhibitor or non-nucleoside reverse-transcriptase inhibitor were matched with women who received darunavir and the same other drugs.
  • Funding: French National Agency for Research on AIDS.

Key results

  • Exposures: raltegravir, 224; dolutegravir, 41; elvitegravir, 44.
  • No significant difference in birth defects by exposure period: G1, 5.5%; G2, 2.7%; G3, 3.0% (P=.18).
  • No neural tube defects occurred in G1 children. Two birth defects occurred in children exposed to dolutegravir (Down syndrome, persistent ductus arteriosus).
  • No significant differences between exposed infants and matched control patients with respect to frequency (6.3% vs 3.7%; P=.26) or type of birth defects.
  • Stillbirth and preterm birth frequencies were similar between infants exposed at conception and matched control patients.
  • No difference in birth defect rates between G2 or G3 and matched control patients.

Limitations

  • Raltegravir was the most commonly used InSTI.