Exploring the Efficacy and Safety of Dolutegravir Plus Lamivudine as a Two-Drug Regimen in Pregnancy: A Case Series of ART-Naïve Women living with HIV

Introduction:The two-drug regimen (2DR) comprising dolutegravir (DTG) and lamivudine (3TC) has been shown to be effective and tolerable in non-pregnant populations, but evidence regarding its safety and efficacy in pregnant women, particularly those newly diagnosed with HIV, remains scarce.This case series describes the maternal virological and immunological outcomes, pregnancy management, and neonatal health in five ART-nave pregnant women treated with DTG/3TC. Methods:We retrospectively evaluated five pregnant women diagnosed with HIV, ART-nave who initiated treatment with DTG/3TC during the second or third trimester.Data collected included baseline HIV-RNA levels, CD4 counts, timing of ART initiation, maternal virological suppression at delivery, mode of delivery, and neonatal HIV and health status.Additional variables included maternal obstetric history, adherence to treatment, and the use of intrapartum antiretroviral prophylaxis.Results: ART was initiated during the second trimester in four women and the third trimester in one.Four achieved undetectable HIV-RNA levels (<20 copies/mL) by delivery, while one had low-level viremia (HIV-RNA 53 copies/mL).Maternal CD4 counts improved across all cases, with no adverse drug reactions reported.Obstetric management included caesarean delivery for Volume 10; Issue 1 Ann Case Rep, an open access journal