High Genetic Barrier Antiretroviral Drugs in Human Immunodeficiency Virus–Positive Pregnancy

Suppression of human immunodeficiency virus (HIV) replication during pregnancy is a key factor to decrease the risk of mother to child transmission (MTCT) [1]. Contrary to the wide experimentation with many different antiretroviral drug combinations performed in the general HIV-positive population over the past years, treatment regimens used in pregnant women to prevent MTCT have been explored to a much lesser extent. Reasons for such limited use of the antiretroviral armamentarium in this context include drug safety concerns and, most importantly, the fact that the vast majority of the HIV-positive pregnancies occur in the developing world, where access to antiHIV drugs has been and is still limited. Most studies have evaluated strategies combining antepartum, intrapartum, and postpartum zidovudine (a nucleoside reverse-transcriptase inhibitor) and/or nevirapine (a nonnucleoside reverse-transcriptase inhibitor [NNRTI]), both of which are relatively well-tolerated and low-cost drugs [2]. Although treatment