HIV infected women: does use of antenatal antiretroviral therapy increase risk of premature delivery?

Data from the United States (US) were presented recently suggesting antiretroviral therapy (ART) during pregnancy in HIV women was not associated with an increased risk of prematurity (1). These findings contradict earlier findings from Europe which demonstrated a small but significant increased risk of premature delivery with use of combination therapy, especially when including a protease inhibitor (PI), and in particular when started before or in early pregnancy (2). But differences in populations and methodology applied could explain much of this apparent contradiction. Clinicians caring for HIV infected women should be aware of these findings.