Considerations when prescribing ART for women

At the first day of the European AIDS Conference 2017, Sharon Walmsley (Senior Scientist at Toronto General Hospital Research Institute) spoke at the Women Against Viruses in Europe (WAVE) forum.  

When considering ART in women it is important to remember the following

• drug trials rarely include significant numbers of women
• Consider whether woman is planning pregnancy (remember safety of ART in pregnancy is generally based on expert opinion not on evidence)
• Consider drug interactions with contraception
• Stribild and Genvoya not recommended in pregnancy as elvitegravir and cobicistat do not cross placenta so baby is not getting adequate levels
• Consider co-morbidity in the older woman especially around menopause and cardiovascular risk
• HIV and/or ARTs seem to cause higher rates of early menopause
• Women living with HIV have higher rates of CVD AND women living with HIV have higher rates of osteoporotic fractures
• Therefore consider change of ART at menopause
• Women represent >50% of people living with HIV however studies of drugs for HIV rarely include significant numbers of women. 

 More to come...