Recommendations for the Use of Antiretroviral Drugs in Pregnant Women with HIV Infection and Interventions to Reduce Perinatal HIV Transmission in the United States

The information in the brief version is excerpted directly from the full-text guidelines. The brief version is a compilation of the tables and boxed recommendations.

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Nucleoside and Nucleotide Analogue Reverse Transcriptase Inhibitors

Tenofovir Alafenamide (Vemlidy, TAF)

Last Updated: December 24, 2019; Last Reviewed: December 24, 2019

Excerpt from Table 8

Note: When using FDCs, refer to other sections in Appendix B and Table 8 for information about the dosing and safety of individual drug components of the FDC during pregnancy.

Excerpt from Table 8
Generic Name
(Abbreviation)
Trade Name
Formulation Dosing Recommendationsa Use in Pregnancy
Tenofovir Alafenamide
(TAF)
Vemlidy

(TAF/BIC/FTC)
Biktarvy

(TAF/FTC)
Descovy

(TAF/EVG/c/FTC)
Genvoya

(TAF/FTC/RPV)
Odefsey

(TAF/DRV/c/FTC)
Symtuza
TAF (Vemlidy)
Tablet:
  • 25 mg
TAF/BIC/FTC (Biktarvy):
  • TAF 25 mg/BIC 50 mg/FTC 200 mg tablet
TAF/FTC (Descovy):
  • TAF 25 mg/FTC 200 mg tablet
TAF/EVG/c/FTC (Genvoya):
  • TAF 10 mg/EVG 150 mg/COBI 150 mg /FTC 200 mg tablet
TAF/FTC/RPV (Odefsey):
  • TAF 25 mg/FTC 200 mg/RPV 25 mg tablet
TAF/DRV/c/FTC (Symtuza):
  • TAF 10 mg/DRV 800 mg/COBI 150 mg/FTC 200 mg tablet
Standard Adult Dose
TAF (Vemlidy):
  • One tablet once daily with food
TAF/BIC/FTC (Biktarvy):
  • One tablet once daily with or without food
TAF/FTC (Descovy):
  • One tablet once daily with or without food
  • Same dose (TAF 25 mg) can be used with or without PK enhancers.
TAF/EVG/c/FTC (Genvoya):
  • One tablet once daily with food
TAF/FTC/RPV (Odefsey):
  • One tablet once daily with food
TAF/DRV/c/FTC (Symtuza):
  • One tablet once daily with food
Pregnancy
PK in Pregnancy:
  • Plasma PKs not significantly altered in pregnancy.
Dosing in Pregnancy:
  • No change in dose indicated.

For guidance about use of combination products in pregnancy, please see the specific sections on other components (i.e., BIC, COBI. DRV, EVG, FTC, RPV).

Low placental transfer to fetus.b

Insufficient data to assess for teratogenicity in humans. No evidence of teratogenicity in rats.

Renal function should be monitored because of potential for renal toxicity.
a Individual ARV drug doses may need to be adjusted in patients with renal or hepatic insufficiency (for details, see the Adult and Adolescent Antiretroviral Guidelines Appendix B, Table 10).
b Placental transfer categories are determined by mean or median cord blood/maternal delivery plasma drug ratio:
          High: >0.6
          Moderate: 0.3–0.6
          Low: <0.3

Key: ARV=antiretroviral; BIC = bictegravir; COBI = cobicistat; DRV/c = darunavir/cobicistat; EVG/c = elvitegravir/cobicistat; FDC = fixed-dose combination; FTC = emtricitabine; PK = pharmacokinetic; RPV = rilpivirine; TAF = tenofovir alafenamide

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