| Atazanavir in pregnancy: impact on neonatal hyperbilirubinemia. | |
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MedLine Citation:
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PMID: 21492993 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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OBJECTIVE: To study the impact on the neonate of maternal antiretroviral therapy with atazanavir (ATV). STUDY DESIGN: An observational study of 22 HIV-infected women receiving, for clinical indications, antiretroviral therapy with ATV 300mg and ritonavir 100mg during pregnancy and their 23 HIV infants (including a twin pair). RESULTS: Mothers had received ATV for a median duration of 19 months [range 3-49] by delivery. At delivery, plasma HIV-RNA was <40copies/mL in all patients. Liver enzymes were normal in 19/22 patients, but one woman had grade 3-4 liver toxicity. Maternal serum bilirubin concentrations were above the upper limit of normal in most patients, with grade 3 toxicity in 5 patients. All but one woman had trough ATV concentrations during pregnancy above the minimum effective concentration. The median cord blood ATV concentration was 130ng/mL [range <30-758]; the cord/maternal ratio was 21%. All neonates were born at term [median 38.2 weeks]. Three neonates had mildly elevated AST transaminase levels. Bilirubin concentrations at birth were significantly higher than maternal concentrations, with a median of 44μm/L [range 24-129]; values on days 2-3 were 63 [8-212]. Five neonates had jaundice requiring phototherapy, without liver damage, and recovered without sequelae. CONCLUSION: Neonates whose mothers were treated with ATV should be monitored for hyperbilirubinemia, which may be due to placental transfer of unconjugated bilirubin from the mother and/or a direct effect of transplacental ATV on bilirubin metabolism in the fetus. |
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Authors:
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Laurent Mandelbrot; Fabienne Mazy; Corinne Floch-Tudal; Françoise Meier; Elie Azria; Catherine Crenn-Hebert; Jean Marc Treluyer; Evelyne Herinomenzanahary; Claudia Ferreira; Gilles Peytavin |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-4-12 |
Journal Detail:
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Title: European journal of obstetrics, gynecology, and reproductive biology Volume: - ISSN: 1872-7654 ISO Abbreviation: - Publication Date: 2011 Apr |
Date Detail:
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Created Date: 2011-4-15 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0375672 Medline TA: Eur J Obstet Gynecol Reprod Biol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2011 Elsevier Ireland Ltd. All rights reserved. |
Affiliation:
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Assistance Publique-Hôpitaux de Paris, Louis Mourier Hospital, Department of Obstetrics and Gynecology, Colombes, France; Paris 7 Diderot University, Paris, France; Inserm U822, IFR69, Le Kremlin-Bicêtre F-94276, France. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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