Darunavir for use in pregnant women with HIV

被引:6
作者
Pope, Robert, Jr. [1 ]
Kashuba, Angela [1 ,2 ]
机构
[1] Univ N Carolina, Eshelman Sch Pharm, Chapel Hill, NC 27515 USA
[2] Univ N Carolina, UNC Ctr AIDS Res, Chapel Hill, NC 27515 USA
关键词
Darunavir; protease inhibitors; pregnancy; human immunodeficiency virus; once-daily; twice-daily; pharmacokinetics; TO-CHILD TRANSMISSION; ONCE-DAILY DARUNAVIR/RITONAVIR; IMMUNODEFICIENCY-VIRUS TYPE-1; LOW-BIRTH-WEIGHT; ANTIRETROVIRAL THERAPY; INFECTED WOMEN; INCREASED RISK; PROTEASE INHIBITORS; PREMATURE DELIVERY; PRETERM DELIVERY;
D O I
10.1080/17512433.2017.1390428
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
Introduction: Combination antiretroviral therapy is recommended during pregnancy to decrease the rate of HIV transmission to the baby and reduce morbidity in the mother. More than 50% of women are prescribed a protease inhibitor-based regimen during pregnancy. Darunavir was recently reclassified as a first-line protease inhibitor for use in pregnancy in the US Department of Health and Human Services Perinatal Guidelines.Areas covered: This is a brief review of the use of protease inhibitor therapy during pregnancy, and a discussion of darunavir's utility in this area. Clinical pharmacology and trial data are reviewed, and the safety, efficacy and dosing of darunavir during pregnancy is discussed.Expert commentary: Darunavir has become an important option in the management of HIV during pregnancy. Both once-daily dosing and twice-daily dosing regimens have shown efficacy in clinical studies. Although a significant reduction in total (protein bound and unbound) plasma concentrations of darunavir has been noted during pregnancy, antiviral activity appears to be maintained with standard dosing. This is likely due to diminished changes in unbound drug concentrations. Preterm delivery and low birth weight have been noted for pregnancies of women on darunavir-containg regimens, but a causal relationship has not yet been demonstrated.
引用
收藏
页码:1317 / 1327
页数:11
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