Pharmacokinetics and therapeutic drug monitoring of antiretrovirals in pregnant women

Highly active antiretroviral therapy is recommended for HIV‐infected pregnant women to prevent mother‐to‐child transmission. The specific physiological background induced by pregnancy leads to significant changes in maternal pharmacokinetics, suggesting potential variability in plasma concentrations...

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Bibliographic Details
Published in:British journal of clinical pharmacology 2008-08, Vol.66 (2), p.179-195
Main Authors: Roustit, Matthieu, Jlaiel, Malik, Leclercq, Pascale, Stanke‐Labesque, Françoise
Format: Article
Language:English
Subjects:
Antiretroviral Therapy, Highly Active
antiretrovirals
Biological and medical sciences
Drug Monitoring
Drug Monitoring - methods
Female
HIV Infections
HIV Infections - drug therapy
HIV Infections - prevention & control
HIV Infections - transmission
HIV mother‐to‐child transmission
HIV Protease Inhibitors
HIV Protease Inhibitors - pharmacokinetics
HIV Protease Inhibitors - therapeutic use
Human immunodeficiency virus
Human viral diseases
Humans
Immunodeficiencies
Immunodeficiencies. Immunoglobulinopathies
Immunopathology
Infectious Disease Transmission, Vertical
Infectious Disease Transmission, Vertical - prevention & control
Infectious diseases
Life Sciences
Medical sciences
Pharmaceutical sciences
pharmacokinetics
Pharmacology. Drug treatments
Pregnancy
Pregnancy Complications, Infectious
Pregnancy Complications, Infectious - drug therapy
Pregnancy Complications, Infectious - prevention & control
protease inhibitors
Reverse Transcriptase Inhibitors
Reverse Transcriptase Inhibitors - pharmacokinetics
Reverse Transcriptase Inhibitors - therapeutic use
Review
therapeutic drug monitoring
Treatment Outcome
Viral diseases
Viral diseases of the lymphoid tissue and the blood. Aids
Viral Load
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Description
Summary:Highly active antiretroviral therapy is recommended for HIV‐infected pregnant women to prevent mother‐to‐child transmission. The specific physiological background induced by pregnancy leads to significant changes in maternal pharmacokinetics, suggesting potential variability in plasma concentrations of antiretrovirals during gestation. Therapeutic drug monitoring (TDM) of protease inhibitors (PIs) and non‐nucleoside reverse transcriptase inhibitors (NNRTIs) is recommended in certain situations, including pregnancy, but its systematic use in HIV‐infected pregnant women remains controversial. This review provides an update of the pharmacokinetic data available for PIs and NNRTIs in pregnant women and highlights the clinical interest of systematic TDM of certain antiretroviral drugs during pregnancy, including nevirapine, nelfinavir, saquinavir, indinavir and lopinavir.
ISSN:0306-5251
1365-2125
DOI:10.1111/j.1365-2125.2008.03220.x