Background: French guidelines recommend a combination antiretroviral therapy (ART) consisting of 2 nucleoside reverse transcriptase inhibitors (NRTIs) and a protease inhibitor (PI) with a PI booster during pregnancy. Due to a decrease in plasma concentrations during the third trimester, an increase in the PI booster to 2 doses per day is recommended. However, this increase may not be necessary to maintain viral load control at delivery. The objective of this study is to assess the impact on the delivery of viral load (VL) of maintaining antiretroviral therapy (ART) dosage in patients with well-controlled HIV at the end of the second trimester. Methods: A retrospective, single-center, observational study was conducted between January 1, 2018, and December 31, 2023. Pregnant patients with HIV managed at our center, who received the recommended combination ART and had undetectable VL at 28 weeks’ gestation, were included. The primary outcome is the proportion with undetectable VL (50 copies/mL at delivery. Conclusions: The absence of a systematic increase in ART dosage does not appear to negatively impact VL at delivery.
Oullion et al. (Wed,) studied this question.