Division of HIV Prevention, National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Expert Rev Anti Infect Ther. 2024 Apr;22(4):153-167. doi: 10.1080/14787210.2024.2334054. Epub 2024 Mar 27.
The HIV/AIDS epidemic has been one of the greatest challenges in global health, significantly affecting women of reproductive potential. Considerable advances in antiretroviral therapy for women living with HIV have contributed to improvements in quality of life, better reproductive and birth outcomes, and a reduced risk of perinatal transmission.
Despite the progress made, persistent challenges in access and adherence to antiretroviral drugs may limit their benefits for some women. More pharmacokinetic and safety studies in pregnant and lactating women are urgently needed, as are prospective surveillance systems to evaluate associations between fetal and infant antiretroviral exposures, drug-drug interactions, and pregnancy outcomes.
Multipurpose technologies, such as combined HIV and other STI or unintended pregnancy prevention, and innovative delivery methods, such as the development of long-acting antiretrovirals, have the potential to reduce adherence challenges and enhance quality of life for women with HIV. Parallel advances in drug safety testing and surveillance are needed to ensure the health and safety of women with or at risk for HIV and children at risk for perinatal transmission.
艾滋病病毒/艾滋病疫情是全球健康面临的最大挑战之一，对具有生育能力的妇女产生了重大影响。抗逆转录病毒疗法在艾滋病毒感染者中的广泛应用，有助于提高生活质量、改善生殖和生育结局，并降低围产期传播的风险。
尽管取得了进展，但在获得和坚持使用抗逆转录病毒药物方面仍然存在持续的挑战，可能会限制这些药物对某些妇女的益处。迫切需要在孕妇和哺乳期妇女中开展更多的药代动力学和安全性研究，以及前瞻性监测系统，以评估胎儿和婴儿暴露于抗逆转录病毒药物、药物相互作用与妊娠结局之间的关联。
多用途技术，如结合艾滋病毒和其他性传播感染或意外怀孕预防，以及创新的给药方法，如长效抗逆转录病毒药物的开发，有可能减少坚持治疗的挑战，提高艾滋病毒感染者的生活质量。需要在药物安全性测试和监测方面取得并行进展，以确保艾滋病毒感染者或有感染风险的妇女以及有围产期传播风险的儿童的健康和安全。
