Table 4.

Preferred antiretroviral therapy for HIV-infected pregnant women

Guideline source	DHHS [37]	EACS [8]	WHO [10,11]
Date of revision	2015	2015	2015f 2013g
Timing of ART	For women already on ART who present in the first trimester, continue current regimen if it is well tolerated and virological suppression has been achieved For women not on ART who present in the first trimester, consider initiating ART as soon as possible	For pregnant women already on ART continue current regimen unless that regimen is contra-indicated in pregnancy For women not on ART who present in pregnancy, initiate ART as soon as possible and no later than the beginning of the second trimester	ART should be initiated in all pregnant and breastfeeding women with HIV, regardless of CD4 count or WHO clinical stage (option B+)
Preferred regimens for ART initiation in pregnancy	NRTI backbones: •ABC/3TCa •TDF/FTC •ZDV/3TC Third agent: •ATV/rb •DRV/rc •EFVd •RALe	Generally the same as for non-pregnant women but: •Do not initiate NVP in pregnancy •EFV can be started in pregnancy or continued in women who are already on therapy with HIV control •LPV/r and ATV/r are preferred PIs •Do not use d4T + ddI or triple NRTI combinations	Same as for non-pregnant adults: •TDF/FTC/EFV •ZDV/3TC/EFV •TDF/FTC/NVP •ZDV/3TC/NVP
Post-partum	ART is recommended for all HIV-infected individuals regardless of CD4 cell count Increase supports in immediate post-partum period as this represents a vulnerable time for ART adherence	ART is recommended for all HIV-infected individuals regardless of CD4 cell count	ART should be continued lifelong for all HIV-infected women

DHHS: Department of Health and Human Services; EACS: European AIDS Clinical Society; WHO: World Health Organization; ART: antiretroviral therapy; NRTI: nucleoside reverse transcriptase inhibitor; ABC: abacavir; 3TC: lamivudine; TDF: tenofovir disoproxil fumarate; ZDV: zidovudine; ATV/r: ritonavir-boosted atazanavir; DRV/r: ritonavir-boosted darunavir; EFV: efavirenz; RAL: raltegravir; PI: protease inhibitor; NVP: nevirapine; LPV/r: ritonavir-boosted lopinavir; d4T: stavudine; ddI: didanosine.

^aFor patients who are HLA-B*5701 negative.

^bBased on extensive experience in pregnancy; once-daily dosing.

^cTwice-daily dosing required.

^dOnly if initiated after 8 weeks' gestational age.

^eAssociated with rapid virological suppression; twice-daily dosing required.

^fPublication of timing of initiation recommendation.

^gPublication of recommended regimens.