The United States Department of Health and Human Services (DHHS) recently updated its guidelines on the use of antiretroviral agents in pregnant women with human immunodeficiency virus (HIV) infection. The guideline gives provisional guidance about the use of dolutegravir in pregnant women. Dolutegravir is newly enumerated as a preferred integrase strand transfer inhibitor to initiate after the first trimester of pregnancy.
However, the guidelines do not recommend the use of dolutegravir during the first trimester (less than 14 weeks [up to 13 6/7 weeks] gestational age by last menstrual period) and in nonpregnant women who are trying to conceive based on the safety concerns about a possible increased risk of neural tube defects. Moreover, when dolutegravir use is continued after delivery, guidelines address clinicians to recommend the use of postpartum contraception and discuss…
