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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Integrase Inhibitors


Glossary of Terms for Supplement
Glossary of Terms for Supplement
Carcinogenic: Producing or tending to produce cancer
  • Some agents, such as certain chemicals or forms of radiation, are both mutagenic and clastogenic.
  • Genetic mutations and/or chromosomal damage can contribute to cancer formation.
Clastogenic: Causing disruption of or breakages in chromosomes
Genotoxic: Damaging to genetic material such as DNA and chromosomes
Mutagenic: Inducing or capable of inducing genetic mutation
Teratogenic: Interfering with fetal development and resulting in birth defects

This class of antiretroviral (ARV) drugs inhibits integrase, the viral enzyme that catalyzes the two-step process of insertion of HIV DNA into the genome of the human cell. Integrase catalyzes a preparatory step that excises two nucleotides from one strand at both ends of the HIV DNA and a final “strand transfer” step that inserts the viral DNA into the exposed regions of cellular DNA. The integrase inhibitor drug class targets this second step in the integration process. Integration is required for the stable maintenance of the viral genome as well as for efficient viral gene expression and replication. Integrase also affects reverse transcription and viral assembly. Host cells lack the integrase enzyme. Because HIV integrase represents a distinct therapeutic target, integrase inhibitors would be expected to maintain activity against HIV that is resistant to other classes of ARV drugs.

Bictegravir (BIC)
Dolutegravir (Tivicay, DTG)
Elvitegravir (Stribild, EVG/COBI/TDF/FTC)
Raltegravir (Isentress, RAL)

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