Pregnancy and Infant Outcomes Among Women Using the Dapivirine Vaginal Ring in Early Pregnancy
Year: 2018
Type: article
Abstract: BACKGROUND: Monthly use of the dapivirine vaginal ring has been shown to be safe and effective for HIV-1 prevention in nonpregnant reproductive-aged women. The impact of dapivirine on pregnancy outcomes and infant is not known. We compared pregnancy incidence and outcomes by study arm among HIV-1-uninfected women who became pregnant while participating in MTN-020/ASPIRE. METHODS: ASPIRE was a randomized, double-blind, placebo-controlled phase III safety and effectiveness study of the dapivirine ring for HIV-1 prevention. Sexually active women aged 18-45 years from Malawi, South Africa, Uganda, and Zimbabwe were enrolled. Urine pregnancy tests were performed monthly, and, if positive, study product was withheld during pregnancy and breastfeeding. Pregnancy-related outcomes included the following: pregnancy incidence, pregnancy outcomes (live birth, preterm birth, pregnancy loss, and congenital anomalies), and infant growth. RESULTS: Of 2629 women enrolled in ASPIRE, 169 became pregnant during follow-up, resulting in 179 incident pregnancies and 181 pregnancy outcomes. No difference in pregnancy incidence by study arm was observed (hazard ratio = 0.93; 95% confidence interval: 0.68 to 1.26). The distribution of pregnancy outcomes was similar by study arm, and no difference was noted in the frequency or pattern of congenital anomalies or infant growth parameters by study arm. CONCLUSIONS: Dapivirine use in the periconception period does not seem to be associated with adverse effects on pregnancy or infant outcomes. Our findings provide support for additional safety studies of the dapivirine ring throughout pregnancy.
Authors: Bonus Makanani, Jennifer E. Balkus, Yuqing Jiao, Lisa M. Noguchi, Thesla Palanee-Phillips, Yamikani Mbilizi, Jothi Moodley, Kenneth Kintu, Krishnaveni Reddy, Samuel Kabwigu, Nitesha Jeenariain, Ishana Harkoo, Nyaradzo Mgodi, Jeanna Piper, Helen Rees, Rachel Scheckter, Richard Beigi, Jared M. Baeten, on behalf of the MTN-020/ASPIRE Study Team
Institutions: Johns Hopkins University, University of Washington, Fred Hutch Cancer Center, University of the Witwatersrand, South African Medical Research Council, MUJHU Research Collaboration, Centre for the AIDS Programme of Research in South Africa, University of Zimbabwe, National Institutes of Health, Family Health International 360, Magee-Womens Hospital
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: Statistical and Data Management Center (SDMC): Microbicide Trials Network, Leadership and Operations Center (LOC): Microbicide Trials Network, Units for HIV/AIDS Clinical Trials Networks, South African Medical Research Council Clinical Trials Unit (MRC CTU), Laboratory Center (LC): Microbicide Trials Network, University of Washington/Fred Hutch Center for AIDS Research, The Johns Hopkins University-Blantyre Clinical Trials Unit, The Johns Hopkins University - Uganda Clinical Trials Unit, Wits HIV Research Group CLINICAL TRIAL UNIT (CTU) reapplication
OpenAlex ID: W2899344433