Biktarvy gives pregnant, HIV positive women a new dose of hope

A few years ago, Orit (a pseudonym) found herself overjoyed with the news of her pregnancy. She spared no expense, spending tens of thousands of shekels on a wide array of genetic tests to ensure the health of her future baby. Yet, amid all these examinations, she overlooked one crucial test – the HIV test, which is offered free of charge to every pregnant woman as part of the national health services. It was only after giving birth that she received the shocking news: despite not belonging to any known risk groups, she was an HIV carrier, and her newborn was diagnosed with AIDS. Today, her baby is undergoing treatment.

In recent years, living with HIV has undergone remarkable advancements. With proper, straightforward treatment, individuals with the virus can lead healthy, fulfilling lives, to the extent that the virus becomes virtually undetectable in their bodies. Thanks to medical progress, HIV-positive women can now conceive and give birth to healthy babies without the fear of transmission.

It is estimated that around 1,200 HIV-positive women of childbearing age currently reside in Israel. After a prolonged struggle, the Ministry of Health agreed to include HIV screening tests as part of the routine prenatal check-ups. Since a year and a half ago, every pregnant woman is required to undergo two HIV tests, at the beginning and end of her pregnancy. These tests are pivotal for early detection and timely treatment, ensuring that both the mothers remain healthy and the babies are born without the virus. Orit’s story underscores the importance of not skipping these tests, even if one believes they are not at risk.

Prof. Lorber explains, “Women with HIV still fear how medical teams will handle their situation and often feel uncomfortable when they arrive at the delivery room. However, the new medications make managing the virus even easier and simpler, ensuring that every HIV-positive woman can easily reach a state where the virus is undetectable in her blood.”

Effective Treatments Today, multiple generations of HIV drugs exist. However, many of the more advanced drugs were not approved for use in pregnant women due to insufficient safety data. Consequently, the treatment options for pregnant women with HIV were limited, often necessitating a medication change upon confirmation of pregnancy.

Recently, this obstacle was overcome with the FDA’s (U.S. Food and Drug Administration) approval of Biktarvy, one of the most advanced HIV medications. Dubbed the “Rolls Royce” of HIV treatments, this single daily pill combines three components and has shown nearly 100% effectiveness in preventing the virus from replicating.

Two recent studies demonstrated that Biktarvy is especially effective in pregnant women, with no significant side effects, no adverse effects on the fetus, and no development of drug resistance. Based on these findings, the FDA granted approval.

This is fantastic news for women who previously had to switch medications. Now, it is possible to prescribe this drug to any woman of childbearing age without worrying that she will need to switch to older, twice-daily medications with more side effects and higher risk of drug interactions. Our current goal in treating people with HIV is to provide one pill a day for life and forget about it, normalizing the condition and making treatment as easy as possible.

The main remaining challenge, after advancements in diagnosing and treating women, is tackling the stigmas and shame. Women with HIV still fear how medical teams will treat them and feel uncomfortable in the delivery room. While there has been progress in the healthcare system, and these women are no longer marked or separated, the stigma persists. The new medications, which make managing the virus even easier and simpler, ensuring that every HIV-positive woman can quickly reach a state where the virus is undetectable in her blood and poses no risk of transmission, can also help combat the remaining stigmas and shame.

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