WHO: Pregnant women with HIV should have access to optimal drug

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With costs dropping for a drug considered one of the more effective antiretroviral treatments, along with evidence showing it is safer than previously thought, the World Health Organization is recommending the medicine be given to pregnant women with HIV.

Efavirenz, a pill usually taken once a day in combination with other medicines, has been found to suppress the level of HIV in patients more effectively than nevirapine, another commonly prescribed medicine used in antiretroviral treatment. Its effectiveness and data showing that patients were able to take it for a longer duration without the virus in their bodies becoming resistant to the drug, translated, according to a WHO update, “into a 1.6-year life expectancy gain for women of childbearing age.”

Laboratory studies on animals though, had indicated that the drug, if administered during pregnancy, could be linked to nervous system birth defects. As a result women taking efavirenz were given a different drug upon becoming pregnant, lowering the odds, in the process, that the drug would be effective in the future.

As increased demand, generic competition and improvements to the drug’s composition that made it part of a once-daily regimen made use efavirenz more widespread, however, data indicated that the rate of birth defects was no higher for it than for other antiretroviral medicines, and was consistent with rates reported for the general population.

WHO reports that using efavirenz will make drug regimens more compatible with treatments for tuberculosis, the most common opportunistic infection for people living with HIV, and, because it is part of a simpler regimen, reduce the workload of stretched health care staff in poor countries.

The organization cautions that research should continue to examine risks of birth defects and other serious side effects for efavirenz and other antiretroviral medicines. In addition, the WHO update notes, drug patent laws and licensing agreements in some countries continue to hinder access to affordable generic versions of efavirenz.


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