التفاصيل البيبلوغرافية
| العنوان: |
Therapeutic drug monitoring of atazanavir/ritonavir in pregnancy. |
| المؤلفون: |
Else, LJ, Jackson, V, Brennan, M, Back, DJ, Khoo, SH, Coulter‐Smith, S, Lambert, JS |
| المصدر: |
HIV Medicine; Nov2014, Vol. 15 Issue 10, p604-610, 7p |
| مصطلحات موضوعية: |
ACADEMIC medical centers, ANALYSIS of variance, COMBINATION drug therapy, DRUG monitoring, HIV infections, LONGITUDINAL method, STATISTICS, DATA analysis, ANTIRETROVIRAL agents, DATA analysis software, ATAZANAVIR, DESCRIPTIVE statistics, RITONAVIR, PREGNANCY |
| مصطلحات جغرافية: |
IRELAND |
| مستخلص: |
Objectives Pregnant women experience physiological changes during pregnancy that can have a significant impact on antiretroviral pharmacokinetics. Ensuring optimal plasma concentrations of antiretrovirals is essential for maternal health and to minimize the risk of vertical transmission. Here we describe atazanavir/ritonavir ( ATV/r) plasma concentrations in a cohort of pregnant women undergoing routine therapeutic drug monitoring ( TDM). Methods Pregnant HIV-positive women received ATV/r as part of their routine pre-natal care. Demographic and clinical data were collected. ATV plasma concentrations ([ ATV]) were determined in the first ( T1), second ( T2) and third ( T3) trimesters and at postpartum ( PP) using liquid chromatography−tandem mass spectrometry ( LC-MS/ MS). Results From January 2007, 44 women (37 black African) were enrolled in the study. All received ATV/r at a dose of 300/100 mg once a day. Twenty-four had received antiretroviral therapy ( ART) prior to pregnancy, and 20 initiated ATV/r in pregnancy. At the time nearest to delivery, 36 patients had undetectable plasma viral loads. [ ATV] values were determined in 11 ( T1), 25 ( T2), 34 ( T3) and 28 ( PP) patients. [ ATV] at 24 hours post-dose ( C24) values significantly lower at T2/ T3 relative to PP. Conclusions This study was carried out in one of the larger cohorts of women undergoing TDM for ATV in pregnancy. Lower [ ATV] values were seen in T2/ T3 compared with T1/ PP. However, [ ATV] were not associated with a lack of virologic suppression at delivery. Nonetheless, careful monitoring of women in pregnancy is required, and dose adjustment of ATV to 400 mg may be an option. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
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