Siemieniuk Reed A C, Lytvyn Lyubov, Mah Ming Jinell, Mullen Rhonda Marama, Anam Florence, Otieno Teresia, Guyatt Gordon H, Taylor Graham P, Beltrán-Arroyave Claudia, Okwen Patrick Mbah, Nduati Ruth, Kinuthia John, Luma Henry Namme, Kirpalani Haresh, Merglen Arnaud, Lesi Olufunmilayo A, Vandvik Per Olav, Agoritsas Thomas, Bewley Susan
Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada; Department of Medicine, University of Toronto, Toronto, Canada
Oslo University Hospital, Forskningsveien 2b, Blindern 0317 Oslo, Norway.
BMJ. 2017 Sep 11;358:j3961. doi: 10.1136/bmj.j3961.
Approximately 1.4 million women living with HIV become pregnant every year. Most women use antiretroviral therapy, to reduce the risk of vertical transmission or for personal health reasons. Using the GRADE framework according to the BMJ Rapid Recommendation process, we make recommendations for optimal choice of combination antiretroviral regimen considering patient values and preferences, the balance of desirable and undesirable outcomes, their uncertainty, and practical issues. We suggest a zidovudine and lamivudine-based regimen over one that includes tenofovir or emtricitabine (weak recommendation). We recommend alternatives over the combination of tenofovir, emtricitabine, and lopinavir/ritonavir (strong recommendation).
每年约有140万感染艾滋病毒的女性怀孕。大多数女性使用抗逆转录病毒疗法，以降低垂直传播风险或出于个人健康原因。根据《英国医学杂志》快速推荐流程使用GRADE框架，我们在考虑患者价值观和偏好、理想与不良结果的平衡、其不确定性以及实际问题的基础上，对联合抗逆转录病毒方案的最佳选择提出建议。我们建议使用基于齐多夫定和拉米夫定的方案，而非包含替诺福韦或恩曲他滨的方案（弱推荐）。我们推荐使用替代方案，而非替诺福韦、恩曲他滨和洛匹那韦/利托那韦的联合方案（强推荐）。
