| Efficacy of low-dose boosted saquinavir once daily plus nucleoside reverse transcriptase inhibitors in pregnant HIV-1-infected women with a therapeutic drug monitoring strategy. | |
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MedLine Citation:
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PMID: 17417070 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The efficacy of low-dose, ritonavir-boosted saquinavir (SQV/rtv) once daily plus 2 nucleoside retrotranscriptase inhibitors (NRTIs) in pregnant human immunodeficiency virus (HIV)-1-infected women was prospectively evaluated, ensuring a SQV minimum concentration (Cmin) >/=100 ng/mL with a therapeutic drug monitoring strategy. The primary clinical endpoint was the percentage of women with an HIV-RNA viral load (VL) of <50 copies/mL at the time of delivery. Forty-nine pregnancy episodes were included, with a median CD4 count and VL of 441/muL and 3710 copies/mL, respectively. Two patients were lost to follow-up and 1 patient discontinued treatment because of abdominal discomfort. SQV levels were in excess of the target Cmin in 43 of 46 episodes (93.4%) in which the end of pregnancy was reached on 1200/100 mg daily. The dosage was increased to 1600/100 mg in the remaining 3 episodes to achieve the target levels. By an intention-to-treat analysis, VL was undetectable at delivery in 43 episodes (87.7%; 95% confidence interval, 78.5-96.9) after a median of 18 weeks of treatment (range, 3-39). In the 3 episodes remaining, VLs of 110,400 copies/mL and no available data were observed after only 3 weeks of treatment. Mild adverse events attributable to SQV/rtv occurred in 6 of 49 pregnancies (12.2%). No cases of HIV vertical transmission were observed. The pharmacokinetics, efficacy, and tolerability of this regimen suggest that once-daily low-dose boosted SQV may be considered an appropriate option in PI-naive or limited-PI-experienced HIV-infected pregnant women. Nevertheless, therapeutic drug monitoring is advisable to maintain appropriate levels throughout pregnancy. |
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Authors:
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Luis F Lopez-Cortes; Rosa Ruiz-Valderas; Antonio Rivero; Angela Camacho; Manuel Marquez-Solero; Jesus Santos; Milagros García-Lazaro; Pompeyo Viciana; Jesus Rodriguez-Baños; Antonio Ocampo |
Publication Detail:
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Type: Journal Article; Multicenter Study |
Journal Detail:
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Title: Therapeutic drug monitoring Volume: 29 ISSN: 0163-4356 ISO Abbreviation: Ther Drug Monit Publication Date: 2007 Apr |
Date Detail:
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Created Date: 2007-04-09 Completed Date: 2007-06-21 Revised Date: 2008-11-21 |
Medline Journal Info:
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Nlm Unique ID: 7909660 Medline TA: Ther Drug Monit Country: United States |
Other Details:
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Languages: eng Pagination: 171-6 Citation Subset: IM |
Affiliation:
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Infectious Diseases Service, Hospitales Universitarios Virgen del Rocío, Seville, Spain. lflopez@telefonica.net |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Drug Monitoring Drug Therapy, Combination Female HIV Infections / drug therapy*, prevention & control, transmission HIV Protease Inhibitors / adverse effects*, blood, therapeutic use Humans Infectious Disease Transmission, Vertical / prevention & control Pregnancy Pregnancy Complications, Infectious / drug therapy* Prospective Studies Reverse Transcriptase Inhibitors / therapeutic use* Ritonavir / therapeutic use Saquinavir / adverse effects*, blood, therapeutic use Viral Load |
| Chemical | |
Reg. No./Substance:
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0/HIV Protease Inhibitors; 0/Reverse Transcriptase Inhibitors; 0/Ritonavir; 127779-20-8/Saquinavir |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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