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Safety of Tenofovir During Pregnancy for the Mother and Fetus: A Systematic Review
Liming Wang1,
Athena P. Kourtis2,
Sascha Ellington2,
Jennifer Legardy-Williams2, and
Marc Bulterys1,3
- Author Affiliations
1Global AIDS Program, US Centers for Disease Control and Prevention, Beijing, China
2Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion
3Division of Global HIV/AIDS, Center for Global Health, US Centers for Disease Control and Prevention, Atlanta, Georgia
Correspondence: Athena P. Kourtis, MD, PhD, MPH, Women's Health and Fertility Branch, Division of Reproductive Health, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, MS-K34, Atlanta, GA 30341 ([email protected]).
Abstract
Tenofovir disoproxil fumarate (TDF) safety during pregnancy has important public health implications. This review summarizes TDF safety during pregnancy, focusing on pregnancy outcomes, congenital anomaly risk, and other potential toxicities on neonates. Although information is limited, TDF appears to be safe during pregnancy. In 6 studies of human immunodeficiency virus type 1 (and/or hepatitis B virus)–infected women receiving TDF during pregnancy, adverse events were mild to moderate; none were considered to be TDF-related. Five studies that followed in utero TDF-exposed infants showed no increased risk of growth or bone abnormalities. One study showed slightly lower infant height at age 1 year, but the significance is unclear. The Antiretroviral Pregnancy Registry database, with 1800 pregnancies exposed to TDF in the first trimester, does not indicate increased congenital anomaly risk with TDF exposure. More evidence collected prospectively, ideally with bone density measurements and randomized trial design, will be optimal to determine the effects of antenatal TDF exposure on children's health.
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