ArticleJournal of acquired immune deficiency syndromes (1999)2016
Reassuring Birth Outcomes With Tenofovir/Emtricitabine/Efavirenz Used for Prevention of Mother-to-Child Transmission of HIV in Botswana.
Article in Journal of acquired immune deficiency syndromes (1999), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 55 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
55 citing papers in PubMed, 2 syntheses or guidelines pooled it, 88 citations in OpenAlex.
- A Systematic Review of the Current Status of Safer Conception Strategies for HIV Affected Heterosexual Couples in Sub-Saharan Africa.AIDS and behavior · 2018Pooled it
- Safety of Tenofovir Disoproxil Fumarate-Based Antiretroviral Therapy Regimens in Pregnancy for HIV-Infected Women and Their Infants: A Systematic Review and Meta-Analysis.Journal of acquired immune deficiency syndromes (1999) · 2017Pooled it
- Trial
- Association between HIV antiretroviral therapy and preterm birth based on antenatal ultrasound gestational age determination: a comparative analysis.AIDS (London, England) · 2019Trial
- Adverse Pregnancy Outcomes Among Women Who Conceive on Antiretroviral Therapy.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2019Trial
- Benefits and Risks of Antiretroviral Therapy for Perinatal HIV Prevention.The New England journal of medicine · 2016Trial
- Prevalence of major structural congenital abnormalities detected on infant surface examination in Botswana, 2014-2022: a birth outcomes surveillance study.BMJ paediatrics open · 2026Article
- Target trials of preconception switch from nevirapine or efavirenz-based antiretroviral therapy to dolutegravir-based antiretroviral therapy on adverse birth and maternal outcomes.AIDS (London, England) · 2025Article
- Association between Maternal HIV and Adverse Birth Outcomes in the Era of Universal Antiretroviral Therapy in Malawi.Journal of acquired immune deficiency syndromes (1999) · 2025Article
- Risk of Adverse Birth Outcomes and Birth Defects Among Women Living With HIV on Antiretroviral Therapy and HIV-Negative Women in Uganda, 2015-2021.Journal of acquired immune deficiency syndromes (1999) · 2025Article
- The association between 2017 American College of Cardiology/American Heart Association guideline for hypertension and neonatal outcomes in Kenya: a retrospective study.Tropical medicine and health · 2025Article
- Birth outcomes following bictegravir exposure during pregnancy.AIDS (London, England) · 2025Article
- How much could anemia-related interventions reduce the HIV disparity in adverse birth outcomes?American journal of epidemiology · 2025Article
- The impact of free antiretroviral therapy for pregnant non-citizens and their infants in Botswana.Journal of the International AIDS Society · 2023Article
- Enhancing interventions for prevention of mother-to-child- transmission of hepatitis B virus.JHEP reports : innovation in hepatology · 2023Review
- Three-year outcomes for women newly initiated on lifelong antiretroviral therapy during pregnancy - Malawi option B.AIDS research and therapy · 2023Article
- Association of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection With Maternal Mortality and Neonatal Birth Outcomes in Botswana by Human Immunodeficiency Virus Status.Obstetrics and gynecology · 2023Article
- Maternal biomarkers of endothelial dysfunction and pregnancy outcomes in women with and without HIV in Botswana.PloS one · 2023Article
- Iron, folic acid, and multiple micronutrient supplementation strategies during pregnancy and adverse birth outcomes in Botswana.The Lancet. Global health · 2022Observational
- High risk of adverse birth outcomes among adolescents living with HIV in Botswana compared to adult women living with HIV and adolescents without HIV.BMC pregnancy and childbirth · 2022Article
Corrections and comments
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Authors and funding
10 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundBefore introduction of tenofovir/emtricitabine/efavirenz (TDF/FTC/EFV), 3-drug antiretroviral therapy (ART) was associated with increased adverse birth outcomes when used for prevention of mother-to-child HIV transmission (PMTCT) in Botswana.
methodsWe extracted obstetric records from all women at the 2 largest maternities in Botswana from 2009-2011 when Botswana National Guidelines recommended zidovudine (ZDV) from 28 weeks gestational age (GA) for CD4 ≥350 and ART for CD4 <350, and again in 2013-2014 after implementation of TDF/FTC/EFV for prevention of mother-to-child HIV transmission regardless of CD4 or GA. We compared the use of TDF/FTC/EFV in pregnancy with other 3-drug ART regimens, and with initiation of ZDV, among women with similar CD4 cell counts. Outcomes included small for gestational age (SGA), preterm delivery (PTD) (<37 weeks GA), and stillbirths (SB).
resultsAmong 9445 HIV-infected women delivering during the study period, 170 were on TDF/FTC/EFV at conception and 1468 initiated TDF/FTC/EFV during pregnancy. Adverse birth outcomes were high overall (3% SB, 21% PTD, and 18% SGA) and among women receiving TDF/FTC/EFV (3% SB, 22% PTD, and 12% SGA). There was no difference in PTD or SB among women initiating TDF/FTC/EFV compared with ZDV or other 3-drug ART, but initiating TDF/FTC/EFV was associated with fewer SGA infants than other 3-drug ART (adjusted odds ratio: 0.4, 95% confidence interval: 0.2 to 0.7).
conclusionsAdverse birth outcomes remain high among HIV-infected women. TDF/FTC/EFV was at least as safe as other ART and associated with fewer SGA infants when initiated during pregnancy. Larger studies are needed to evaluate birth outcomes and congenital abnormalities among women on TDF/FTC/EFV at conception.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.