Tenofovir-Lamivudine-Efavirenz
Standard first-line ART for HIV-positive pregnant women per WHO 2021 guidelines. Tenofovir disoproxil fumarate (TDF) + lamivudine (3TC) + efavirenz (EFV) as a fixed-dose combination. Efavirenz was historically avoided in T1 due to neural tube defect risk in animal studies; large human registry data (>2,000 T1 exposures) have not confirmed this risk in humans. WHO and UNAIDS now endorse EFV-based regimens throughout pregnancy. Starting or continuing ART is critical to prevent mother-to-child transmission (MTCT) of HIV — benefits far outweigh any theoretical risks.