Hypertension in a Randomized Trial of Dolutegravir- Versus Efavirenz-Based Antiretroviral Therapy in Pregnant and Postpartum Women with HIV.

In 30 seconds

This randomized controlled trial evaluated incident hypertension in 626 pregnant and postpartum women with HIV receiving different antiretroviral therapies: dolutegravir (DTG) + emtricitabine/tenofovir alafenamide (TAF), DTG + emtricitabine/tenofovir disoproxil fumarate (TDF), or efavirenz (EFV)/emtricitabine/TDF. The composite incident hypertension occurred in 49% of participants, with no significant differences between treatment arms.

Key findings

• 49% of women experienced the composite incident hypertension outcome.
• Hypertension was numerically more likely in the DTG treatment arms.
• Each additional 5 kg of weight was associated with an 8%-17% higher hazard of hypertension.
• 4.3% of participants had gestational hypertension with no apparent differences between treatment arms.

Why it matters

The findings underscore the need for careful monitoring of blood pressure and weight in pregnant and postpartum women with HIV, particularly those receiving DTG-based therapies, to ensure maternal health and safety.