Antenatal atazanavir: a retrospective analysis of pregnancies exposed to atazanavir.
Antenatal atazanavir: a retrospective analysis of pregnancies exposed to atazanavir.
复制标题
DOI：
10.1155/2014/961375
复制
发表时间：
2014
影响因子：
--
通讯作者：
de Ruiter A
中科院分区：
文献类型：
--
作者：
Samuel M;Bradshaw D;Perry M;Chan SY;Dhairyawan R;Byrne L;Smith K;Zhou J;Short CE;Naftalin C;Offodile N;Mandalia S;Roedling S;Shah R;Brook G;Poulton M;Rodgers M;Sarner L;Noble H;Hay P;Anderson J;Natha M;Hawkins D;Taylor G;de Ruiter A
导论.关于产前阿扎那韦的耐受性、安全性或有效性的数据很少。我们报告我们的临床经验，阿扎那韦使用在怀孕。方法. 2004年至2010年期间，在12个伦敦中心对阿扎那韦暴露妊娠的回顾性医疗记录进行了审查。结果在135名妇女中有145名怀孕：89名在服用阿扎那韦联合抗逆转录病毒治疗（cART）时怀孕，“孕前”阿扎那韦暴露; 27名在怀孕期间开始阿扎那韦为基础的cART作为“一线”; 29名在怀孕期间从另一种cART方案“转换”为阿扎那韦为基础的方案。胃肠道不耐受，需要阿扎那韦停止发生在五个怀孕。自限性新发转氨酶升高在一线用药中最常见，发生率为11.0%。5例转换妊娠在存在转氨酶的情况下开始使用阿扎那韦，其中2例因持续性转氨酶而停用阿扎那韦。在89.3%的孕前、56.5%的一线和72.0%的转换暴露中，HIV-VL < 50拷贝/mL。单胎早产（<37周）发生在11.7%的孕前、9.1%的一线和7.7%的转换暴露中。4名婴儿需要光疗。有一个母亲对儿童的传播，在一个不好的粘附妇女。结论.这些数据表明阿扎那韦耐受性良好，可以安全地作为妊娠期联合抗逆转录病毒治疗的组成部分。
Introduction. There are few data regarding the tolerability, safety, or efficacy of antenatal atazanavir. We report our clinical experience of atazanavir use in pregnancy. Methods. A retrospective medical records review of atazanavir-exposed pregnancies in 12 London centres between 2004 and 2010. Results. There were 145 pregnancies in 135 women: 89 conceived whilst taking atazanavir-based combination antiretroviral therapy (cART), “preconception” atazanavir exposure; 27 started atazanavir-based cART as “first-line” during the pregnancy; and 29 “switched” to an atazanavir-based regimen from another cART regimen during pregnancy. Gastrointestinal intolerance requiring atazanavir cessation occurred in five pregnancies. Self-limiting, new-onset transaminitis was most common in first-line use, occurring in 11.0%. Atazanavir was commenced in five switch pregnancies in the presence of transaminitis, two of which discontinued atazanavir with persistent transaminitis. HIV-VL < 50 copies/mL was achieved in 89.3% preconception, 56.5% first-line, and 72.0% switch exposures. Singleton preterm delivery (<37 weeks) occurred in 11.7% preconception, 9.1% first-line, and 7.7% switch exposures. Four infants required phototherapy. There was one mother-to-child transmission in a poorly adherent woman. Conclusions. These data suggest that atazanavir is well tolerated and can be safely prescribed as a component of combination antiretroviral therapy in pregnancy.