A 24-year-old pregnant woman at 8 weeks gestation is diagnosed with HIV. Her ART regimen must be adjusted. Which antiretroviral is contraindicated in the first trimester due to risk of neural tube defects?
- A Nevirapine
- B Efavirenz ✓
- C Ritonavir
- D Abacavir
Correct answer: B. Efavirenz
Explanation
Efavirenz is contraindicated in the first trimester of pregnancy due to reported neural tube defects in animal studies and human case reports. The critical window is 5 to 6 weeks post-conception. Dolutegravir was also scrutinized but efavirenz remains the classic teaching. Nevirapine, ritonavir, and abacavir are not first-trimester teratogens.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.