Evidence map›Paper›PMID 41668266›Full record

ArticleHIV medicine2026

Perinatal and early infant outcomes after first-versus second-generation integrase strand transfer inhibitor use in pregnancy.

Rosa Balleny, Jeffrey Man Hay Wong, Terry Lee, Ari Bitnun, Isabelle Boucoiran, Jason Brophy, Jeannette Comeau, Fatima Kakkar, Athena McConnell, Laura Sauvé and 3 more

Abstract read
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In one paragraph

Article in HIV medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Rosa BallenyDepartment of Obstetrics and Gynecology, University of British Columbia, Vancouver, British Columbia, Canada.
Jeffrey Man Hay WongDepartment of Obstetrics and Gynecology, University of British Columbia, Vancouver, British Columbia, Canada.ORCID https://orcid.org/0000-0001-9164-3383
Terry LeeCentre for Advancing Health Outcomes, Vancouver, British Columbia, Canada.
Ari BitnunDepartment of Pediatrics, University of Toronto, Toronto, Ontario, Canada.
Isabelle BoucoiranDepartment of Obstetrics and Gynecology, Université de Montréal, Montréal, Quebec, Canada.
Jason BrophyDepartment of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada.
Jeannette ComeauDepartment of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada.
Fatima KakkarDepartment of Pediatrics, Université de Montréal, Montréal, Quebec, Canada.
Athena McConnellDepartment of Pediatrics, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
Laura SauvéDepartment of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.
Joel SingerCIHR Pan-Canadian Network for HIV and STBBI Clinical Trials Research, Montréal, Quebec, Canada.
Alena Tse-ChangDepartment of Pediatrics, University of Alberta, Edmonton, Saskatchewan, Canada.
Deborah MoneyDepartment of Obstetrics and Gynecology, University of British Columbia, Vancouver, British Columbia, Canada.

Funding

Canadian HIV Trials Network, Canadian Institutes of Health ResearchFonds de recherche du QuébecViiV Healthcare
6 · The paper itself

Abstract

introductionIntegrase strand transfer inhibitors (INSTIs) are first-line antiretroviral medications used in pregnancy. Pre-clinical research suggests adverse effects in human stem cells associated with second- versus first-generation INSTIs. We compared perinatal and early infant outcomes after exposure to first- versus second-generation INSTIs.

methodsData were taken from the Canadian Perinatal HIV Surveillance Program. Infants born between January 1, 2010, and December 31, 2023, with in utero INSTI exposure were included. Univariate analysis compared perinatal and early infant outcomes between first- and second-generation INSTI exposures. Multivariable logistic regression was completed to identify independent associations between INSTI class and perinatal outcomes.

resultsA total of 1160 infants were included: 433 exposed to first-generation INSTIs and 727 to second-generation. There was a non-significant finding of fewer small-for-gestational-age (SGA) infants with exposure to second-generation INSTIs (odds ratio [OR] = 0.75; 95% confidence interval [CI] = 0.55-1.01, p = 0.058), which remained non-significant in multivariable analysis (OR = 0.72, 95% CI = 0.49-1.07, p = 0.105). There was a non-significant finding of increased preterm births with exposure to second-generation INSTIs (OR = 1.40, 95% CI = 0.97-2.00, p = 0.070), which remained non-significant in multivariable analyses (OR = 1.01, 95% CI = 0.62-1.66, p = 0.962). There was a non-significant increase in infant deaths in the second-generation INSTI group compared to the first-generation group (6 vs. 0, p = 0.089). No differences were observed in HIV transmission (p = 0.208).

conclusionsThere were no significant associations between second-generation INSTIs and adverse perinatal outcomes compared to first-generation INSTIs. These findings support the ongoing use of second-generation INSTIs in pregnancy with continued careful surveillance of perinatal outcomes.

Indexed as

HIV InfectionsHIV Integrase InhibitorsPregnancy Complications, InfectiousAdultCanadaFemaleHumansInfantInfant, NewbornInfant, Small for Gestational AgeInfectious Disease Transmission, VerticalMalePregnancyPregnancy OutcomeHIV Integrase InhibitorsHIVintegrase Strand transfer inhibitorobstetricspaediatricspregnancy

Identifiers

PMID41668266
PMCPMC13140034

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Registered trials

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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.