多替拉韦对感染艾滋病毒女性产科结局的影响：一项回顾性队列研究。

The effect of dolutegravir on obstetrical outcomes among women living with HIV: A retrospective cohort study.

作者信息

Al Naimi Ammar, Chang Charlotte, Rawizza Holly, Olaifa Oluwaseun, Ogunsola Olabanjo, Okonkwo Prosper, Kanki Phyllis

机构信息

Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA.

Department of Obstetrics and Gynecology, Buergerhospital, Frankfurt, Germany.

出版信息

J Obstet Gynaecol Res. 2025 Jun;51(6):e16349. doi: 10.1111/jog.16349.

DOI:10.1111/jog.16349

PMID:40545832

Abstract

OBJECTIVE

To assess the effect of dolutegravir (DTG) on obstetrical outcomes for women living with HIV (WLWH).

METHODS

This retrospective cohort study evaluated adult WLWH in antenatal care between 2016 and 2022 at two Nigerian centers. Patients were stratified into three antiretroviral therapy (ART) exposure groups: non-DTG ART, DTG-switch, and DTG. Multivariate linear and logistic regression models were utilized to assess the association between the type of ART and gestational weight gain (GWG), small for gestational age (SGA), gestational hypertension, and preterm birth.

RESULTS

The study included 1839 (77.1%) non-DTG users, 359 (15%) DTG users, and 188 (7.9%) DTG switchers. The adjusted association between DTG exposure and GWG was 0.72 (-0.08, 1.53) kg and 0.51 (-0.51, 1.54) kg for the DTG and DTG-switch groups, respectively, compared to other ARTs. The adjusted odds ratios for gestational hypertension were 0.47 (0.09, 2.49) and 1.31 (0.43, 4.02), 0.57 (0.22, 1.52) and 0.73 (0.25, 2.10) for preterm birth, and 0.55 (0.25, 1.20) and 0.26 (0.08, 0.83) for SGA in DTG and DTG-switch, respectively, compared to other ARTs.

CONCLUSIONS

DTG therapy is not associated with the risk of gestational hypertension nor preterm birth, and antenatal ART switching to DTG decreases the risk of growth restriction.

摘要

目的

评估多替拉韦（DTG）对感染人类免疫缺陷病毒（HIV）的女性（WLWH）产科结局的影响。

方法

这项回顾性队列研究评估了2016年至2022年期间在尼日利亚两个中心接受产前护理的成年WLWH。患者被分为三个抗逆转录病毒疗法（ART）暴露组：非DTG ART组、DTG转换组和DTG组。采用多变量线性和逻辑回归模型评估ART类型与孕期体重增加（GWG）、小于胎龄儿（SGA）、妊娠期高血压和早产之间的关联。

结果

该研究纳入了1839名（77.1%）非DTG使用者、359名（15%）DTG使用者和188名（7.9%）DTG转换者。与其他ART相比，DTG组和DTG转换组中DTG暴露与GWG的调整后关联分别为0.72（-0.08，1.53）kg和0.51（-0.51，1.54）kg。与其他ART相比，DTG组和DTG转换组妊娠期高血压的调整后比值比分别为0.47（0.09，2.49）和1.31（0.43，4.02），早产的调整后比值比分别为0.57（0.22，1.52）和0.73（0.25，2.10），SGA的调整后比值比分别为0.55（0.25，1.20）和0.26（0.08，0.83）。