What's new for antiretroviral treatment in women with HIV

Factors associated with sex differences in viral non‐suppression in the Swedish InfCareHIV cohort: An observational real‐world study

“…This indicates that the implications of experiencing side effects may differ between women and men, although reasons for this are unclear and need further investigation. RCTs are generally underpowered to detect sex differences regarding ART adverse events and experience of side effects [2]. However, other studies have found higher frequencies of adverse events [12] and higher risk of ART discontinuation due to ART toxicity [38] in women than in men.…”

“…However, women are under‐represented in randomized clinical trials (RCTs) assessing outcomes of antiretroviral treatment (ART). Except for two all‐female studies, the proportion of women in clinical trials before 2015 varied between 7% and 30% [2]. In a meta‐analysis of 40 registrational trials, no overall significant difference could be found between women and men in ART efficacy [3].…”

Associations between female birth sex and risk of chronic kidney disease development among people with HIV in the USA: A longitudinal, multicentre, cohort study

“…Women have been reported to have approximately 19% higher concentrations of TDF than men, 50 which may explain some of the increased risk of CKD development among women observed in this study as TDF plasma concentrations are associated with increased risk of kidney tubular dysfunction. 51 Additionally, numerous studies suggest, when engaged in HIV care, WWH have lower HIV viral loads than men and higher levels of inflammatory markers. 52 , 53 , 54 , 55 , 56 , 57 , 58 Even with effective ART therapy, this increased inflammation may persist and mimic the natural inflammation process associated with aging in the general population thereby increasing the baseline risk of CKD development among PWH.…”

Towards an ideal antiretroviral regimen for the global HIV epidemic

“…However, sex differences in antiretroviral pharmacokinetics may influence drug efficacy and predisposition to certain adverse events [22] . Furthermore, the pharmacological management of HIV requires consideration of key sexual and reproductive health concerns, including drug–drug interactions with hormonal contraception, use of ARVs to prevent mother-to-child transmission, and management of HIV-infected women in the context of age-associated comorbidities and menopause [23] . Although most historical ART regimens are safe in pregnancy and for the fetus, there is scant data on newer drugs, and studies for these populations are still under way or yet to be initiated (Table 2 ).…”