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Updated: Nov 22, 2025

Rapid Screening of HIV Reverse Transcriptase and Integrase Inhibitors
Published on: April 9, 2014
Interactions between highly active antiretroviral therapy and over-the-counter agents: a cautionary note
Jerome Federspiel1,2, Melanie J Bukhari2, Matthew M Hamill3,4
1Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, North Carolina, USA jfederspiel@gmail.com.
Abstract:
Highly active antiretroviral therapy (HAART) has dramatically lowered rates of mother-to-child HIV transmission among patients with access to treatment. Barriers to complete viral suppression increase rates of transmission, even with only low levels of viral replication. Here, we present the case of a pregnant patient who developed a detectable viral load in pregnancy, thought to be related to calcium supplement consumption or emesis while using a dolutegravir-based HAART regimen. Ultimately, with adjustments, the patient again reached an undetectable viral load and had an uncomplicated perinatal and neonatal outcome. We discuss new data on the use of dolutegravir in pregnancy and precautions for maintaining viral suppression while on antiretroviral therapy in pregnancy.
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