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Safety and Tolerability of Antiretrovirals during Pregnancy.
MedLine Citation:
PMID:  21603231     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Combination antiretroviral therapy (CART) dramatically decreases mother-to-child HIV-1 transmission (MTCT), but maternal adverse events are not infrequent. A review of 117 locally followed pregnancies revealed 7 grade ≥3 AEs possibly related to antiretrovirals, including 2 hematologic, 3 hepatic, and 2 obstetric cholestasis cases. A fetal demise was attributed to obstetric cholestasis, but no maternal deaths occurred. The drugs possibly associated with these AE were zidovudine, nelfinavir, lopinavir/ritonavir, and indinavir. AE or intolerability required discontinuation/substitution of nevirapine in 16% of the users, zidovudine in 10%, nelfinavir in 9%, lopinavir/ritonavir in 1%, but epivir and stavudine in none. In conclusion, nevirapine, zidovudine, and nelfinavir had the highest frequency of AE and/or the lowest tolerability during pregnancy. Although nevirapine and nelfinavir are infrequently used in pregnancy at present, zidovudine is included in most MTCT preventative regimens. Our data emphasize the need to revise the treatment recommendations for pregnant women to include safer and better-tolerated drugs.
Authors:
Adriana Weinberg; Jeri Forster-Harwood; Jill Davies; Elizabeth J McFarland; Jennifer Pappas; Kay Kinzie; Emily Barr; Suzanne Paul; Carol Salbenblatt; Elizabeth Soda; Anna Vazquez; Myron J Levin
Publication Detail:
Type:  Journal Article     Date:  2011-04-11
Journal Detail:
Title:  Infectious diseases in obstetrics and gynecology     Volume:  2011     ISSN:  1098-0997     ISO Abbreviation:  Infect Dis Obstet Gynecol     Publication Date:  2011  
Date Detail:
Created Date:  2011-05-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9318481     Medline TA:  Infect Dis Obstet Gynecol     Country:  Egypt    
Other Details:
Languages:  eng     Pagination:  867674     Citation Subset:  IM    
Affiliation:
School of Medicine University of Colorado Denver, Research Complex 2, Mail Stop 8604, 12700 E. 19th Avenue, Aurora, CO 80045, USA.
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