Pregnancy outcomes following exposure to efavirenz-based antiretroviral therapy in the Republic of Congo

Francesca Bisio, Elena Nicco, Anna Calzi, Daniele Roberto Giacobbe, Alessio Mesini, Hubert Banguissa, Nicole Edith Vividila, Pélagie Mahoungou, Jean Denis Boumba, Franc Astyanax Mayinda Mboungou, Bianca Bruzzone, Sandra Ratto, Giancarlo Icardi, Claudio Viscoli, Paolo Bruzzi

Research output: Contribution to journalArticlepeer-review


WHO recently recommended efavirenz (EFV) use for HIV infection through pregnancy, breastfeeding and childbearing age. However the use of EFV during pregnancy remains of concern and not all national guidelines reflect WHO advice. Few data are available concerning pregnancy outcomes. The objective of our study was to evaluate pregnancy outcomes in a cohort of women who conceived on EFV. A retrospective, multicenter cohort study was conducted in Pointe Noire, Republic of Congo (September 2005- June 2012). The following adverse pregnancy outcomes were considered: births defects, low birth weight, premature delivery, stillbirth and abortion, stratified by antiretroviral exposure at the time of conception. During the study period, 188 women conceived on antiretrovirals: 35 (18.6%) on EFV-based regimens and 153 (81.4%) on nevirapine-based regimens. Adverse pregnancy outcomes were observed in 17/35 (48.6%, 95% CI 33.0-64.4%) women in the EFV group and in 43/153 (28.1%, 95% CI 21.6-35.7%) in the non-EFV group (p=0.019). No birth defect was observed in either group. An increased incidence of adverse pregnancy outcomes was observed in the EFV group. As WHO is promoting a widespread use of EFV also for women in childbearing age, our study emphasizes the importance of launching large prospective cohort studies investigating pregnancy outcomes in exposed women.

Original languageEnglish
Pages (from-to)185-192
Number of pages8
JournalNew Microbiologica
Issue number2
Publication statusPublished - Apr 1 2015


  • Africa
  • Birth defects
  • Efavirenz
  • Pregnancy
  • Pregnancy outcome

ASJC Scopus subject areas

  • Microbiology (medical)
  • Medicine(all)

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