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Abstract
Increased incidence of spontaneous abortion during first trimester exposure to efavirenz
Joao E.1, Calvet G.1, Sidi L.1, Cruz L.1, Cardoso C.1, Cunha C.1, Silva R.1, d´Ippolito M.1, Menezes J.1
Objectives: An increasing number of women are becoming pregnant while taking regimens containing efavirenz (EFV). This raises concerns of potential EFV-induced fetal effects. The aim of this study was to examine the risk of spontaneous abortion (SA) after reported exposure to EFV during the first trimester of gestation.
Methods: Data were abstracted from an observational cohort of HIV+ pregnant women who delivered at a tertiary public hospital in Rio de Janeiro, from January 1996 to December 2006. Antiretroviral therapy (ART) was assessed to detect potential association with SA. ART exposure during conception was stratified as: None (R1 n=655); monotherapy/double therapy with two nucleosides (R2 n=37), HAART with efavirenz (R3 n=30) and other HAART containing regimens (R4 n=68). If a woman delivered more than one baby in different pregnancies during the study period, only information regarding the first pregnancy was analyzed. Association of ART exposure with the outcome was evaluated using Pearson´s Chi-squared test with simulated p-value (based on 10,000 replicates). Data were analyzed by SPSS version 12.0.
Results: Incidence of spontaneous abortion in the cohort was 6/790 (0.8%). 135(17.1%) women became pregnant while taking ART. Median time of EFV exposure was 13 weeks. Incidence of SA was: R1= 0.2%, R2=2.7%, R3=6.7% and R4=2.9% with a statistically significant difference between groups (p<0.005). No birth defects were observed in EFV exposure group.
Conclusions: An increased incidence of spontaneous abortions was observed in women exposed to EFV during first trimester. Women should be continuously advised to shift to an alternative ARV before pregnancy or to use at least two contraceptive methods to avoid accidental exposure to EFV.
4th IAS Conference on HIV Pathogenesis, Treatment and Prevention
Abstract no.
TUPEB113
Suggested Citation
"JoaoE., et al.
Increased incidence of spontaneous abortion during first trimester exposure to efavirenz.
Poster exhibition:
4th IAS Conference on HIV Pathogenesis, Treatment and Prevention:
Abstract no.
TUPEB113"
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