Table 5. Antiretroviral recommendations in treatment-naive HIV-infected women.

Classes	Preferred agents	Alternative agents	Comments
NRTI	Abacavir/lamivudine, TDF/emtricitabine, TDF/lamivudine	Zidovudine/lamivudine	• Although data are limited, TAF plasma concentrations in pregnant women are similar to those seen in non-pregnant adults.
		TAF/emtricitabine
NNRTI	-	Efavirenz	• Although birth defects have been reported in animal studies of efavirenz, there has been no evidence of an increased risk for efavirenz-related birth defects in human pregnancy.
		Rilpivirine	• Etravirine is not recommended because of limited information regarding its use in pregnant women.
PI	Atazanavir/ritonavir, Darunavir/ritonavir	-	• Lopinavir/ritonavir is not recommended except in special circumstances, since it may increase the risk of preterm delivery and cause significant nausea compared to preferred/alternative agents.
			• Cobicistat-boosted PI agents are not recommended except in special circumstances, because of potential low drug levels and the occurrence of viral rebound in the second and third trimesters.
ITSTI	Raltegravir, Dolutegravir	-	• Elvitegravir/cobicistat is not recommended because of limited information regarding its use and inadequate levels of elvitegravir and cobicistat in the second and third trimesters.

HIV, human immunodeficiency virus; NRTI, nucleoside reverse transcriptase inhibitor; TDF, tenofovir disoproxil fumarate; TAF, tenofovir alafenamide;-NNRTI, non-nucleoside reverse transcriptase inhibitor; PI, protease inhibitor; INSTI, integrase strand transfer inhibitor.