ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2026
Safety of Short-course Weekly Rifapentine and Isoniazid (3HP) for TB Preventive Treatment at Conception and During First Trimester in Women With HIV: A Secondary Analysis of the WHIP3TB trial.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe safety of a 3-month weekly rifapentine-isoniazid (3HP) for tuberculosis prevention in HIV-positive pregnant women on antiretroviral treatment is unknown. As part of the WHIP3TB trial, 3HP administered once or annually for 2 years was compared to 6 months of isoniazid. We report outcomes among women who became pregnant, with drug exposure in early pregnancy.
methodsWomen were classified as exposed if conception occurred while taking study drug, and unexposed if conception occurred after the last dose. Outcomes included live birth, stillbirth, or abortion. A composite adverse pregnancy outcome was defined as any of the following: stillbirth, spontaneous abortion, low birth weight (<2500 g), preterm delivery (<37 weeks' gestation), or major congenital anomalies. Outcomes were compared between exposed and unexposed groups.
resultsAmong 2207 women aged 15-49 years enrolled between November 2016 and November 2017, 236 pregnancies occurred in 222 participants. Fifty-seven (24%) were exposed to study drug (51 in 3HP arm, 6 in 6 months of isoniazid arm) and 179 were unexposed. Median age was 32 years, median antiretroviral treatment duration 2.9 years (interquartile range; 1.2-4.9 years) and median CD4 count 522 cells/L; [interquartile range, 345-684). Of 219 pregnancies with known outcomes, 162 (74%) were live births, 51 (23%) abortions, and 6 (3%) stillbirths. Spontaneous abortions occurred at similar frequencies among exposed (12% [7/57]) and unexposed (14% [22/162]) groups with comparable rates of composite adverse outcomes (33% [19/57] vs 35% [56/162]).
conclusionsSpontaneous abortion and composite adverse pregnancy outcomes following first-trimester exposure to 3HP were comparable between exposed and unexposed groups, supporting the safety of 3HP in pregnancy.
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