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suppression to persist for weeks after stopping ART. We were performed by G.A., J.L. and K.B. G.A, C.R. and S.L.
believe this could be because of low pre-ART viral loads in co-wrote the article.
our population (because of women with less advanced
disease starting ART in pregnancy).
Funding information
Our study had several limitations. Firstly, our results are based This project was funded by the National Institute of Child
on a small number of observations making generalisability Health and Human Development, and the National Institute
challenging. Secondly, we did not report on minor drug of Allergy and Infectious Diseases, NIH grant: R01HD061265.
resistance variants and, finally, more than half (63%) of women
tested at a median time of 5 weeks from EFV cessation were Data availability statement
still virally suppressed, which may suggest that we might
have tested for resistance strain development early. Thirdly, Data and associated documentation from this study will be
we could not determine why the 7-day tail was inconsistently made available for external use only under a data-sharing
applied at the time of ART cessation and could therefore have agreement that provides for (1) a commitment to using the
missed evaluating possible confounders related to this factor. data only for research purposes and not to identify any
Conclusion individual participant; (2) a commitment to securing the
data using appropriate computer technology; and (3) a
Although guidelines no longer recommend discontinuation commitment to destroying or returning the data after
of ART after pregnancy, our study has general applicability analyses are completed.
for those requiring permanent or temporary treatment
discontinuation when receiving an EFV-based regimen, Disclaimer
informing the risk of mutation emergence in the setting of
abrupt three-drug discontinuation versus discontinuing with The views and opinions expressed in this article are those of
a TDF/FTC tail. Furthermore, despite the shift to the use of the authors and do not necessarily reflect the official policy or
newer drugs such as dolutegravir for which there is less position of any affiliated agency of the authors.
concern about the emergence of resistance than with NNRTIs,
our data are relevant to millions of individuals still on References
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