The World Health Organization has recommended the use of antiretroviral drug dolutegravir (DTG) as a preferred first and second-line treatment for all HIV cases, including pregnant women and those who have the potential to give birth.

Initial studies by the United Nations health agency highlighted a possible link between DTG and birth defects.

Defects to the brain and spinal cord, that cause conditions like spina bifida in infants born to women who used the drug at the time of conception.

This safety concern came from a May 2018 research conducted in Botswana, that found four cases of such so-called neural tube defects, out of 426 women who became pregnant while taking DTG.

This resulted in a lot of countries advising expectant mothers and those with childbearing potential, to take an alternative antiviral medication called efavirenz (EFV).

However, new expanded evidence-based data from two large clinical trials comparing the efficacy and safety of, in Africa, reveal that the risks of neural tube defects are significantly lower than initial studies had suggested.

“DTG is more effective, easier to administer and has fewer side effects than alternatively prescribed drugs,” said WHO.

It also has a high genetic barrier to developing drug resistance, which is important given the rising trend of resistance to EFV and other regimens.

12 out of 18 countries which were surveyed by WHO in 2018 reported pre-treatment drug resistance levels exceeding the recommended threshold of 10 percent.

This year, 82 low and middle-income countries reported that they would be transitioning to DTG-based HIV treatment regimens.

These newly updated recommendations are geared towards helping even more countries to improve their HIV policies.