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Thus, French guidelines recommend switching to rilpivirine-free combinations (RFCs) during pregnancy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To describe the characteristics of women initiating pregnancy while on rilpivirine and to compare the outcomes for virologically suppressed subjects continuing rilpivirine until delivery versus switching to an RFC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In the ANRS-EPF French Perinatal cohort, we included women on rilpivirine at conception in 2010\u201318. Pregnancy outcomes were compared between patients continuing versus interrupting rilpivirine. In women with documented viral suppression (&amp;lt;50 copies\/mL) before 14\u2009weeks of gestation (WG) while on rilpivirine, we compared the probability of viral rebound (\u226550 copies\/mL) during pregnancy between subjects continuing rilpivirine versus those switching to RFC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 247 women included, 88.7% had viral suppression at the beginning of pregnancy. Overall, 184 women (74.5%) switched to an RFC (mostly PI\/ritonavir-based regimens) at a median gestational age of 8.0 WG. Plasma HIV-1 RNA nearest delivery was &amp;lt;50 copies\/mL in 95.6% of women. Among 69 women with documented viral suppression before 14 WG, the risk of viral rebound was higher when switching to RFCs than when continuing rilpivirine (20.0% versus 0.0%, P\u2009=\u20090.046). Delivery outcomes were similar between groups (overall birth defects, 3.8\/100 live births; pregnancy losses, 2.0%; preterm deliveries, 10.6%). No HIV transmission occurred.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In virologically suppressed women initiating pregnancy, continuing rilpivirine was associated with better virological outcome than changing regimen. We did not observe a higher risk of adverse pregnancy outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1093\/jac\/dkaa017","type":"journal-article","created":{"date-parts":[[2020,1,13]],"date-time":"2020-01-13T20:12:15Z","timestamp":1578946335000},"page":"1324-1331","source":"Crossref","is-referenced-by-count":11,"title":["Rilpivirine in HIV-1-positive women initiating pregnancy: to switch or not to switch?"],"prefix":"10.1093","volume":"75","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4920-8369","authenticated-orcid":false,"given":"Pierre","family":"Frange","sequence":"first","affiliation":[{"name":"Laboratoire de Microbiologie clinique, Assistance Publique\u2014H\u00f4pitaux de Paris (APHP), H\u00f4pital Necker\u2014Enfants malades, Paris, France"},{"name":"EA7328 PACT, Institut Imagine, Universit\u00e9 de Paris, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roland","family":"Tubiana","sequence":"first","affiliation":[{"name":"Service de Maladies 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