Tenofovir alafenamide use in pregnant and lactating women living with HIV

被引:27
作者
Eke, Ahizechukwu C. [1 ,2 ]
Brooks, Kristina M. [3 ]
Gebreyohannes, Rahel D. [4 ]
Sheffield, Jeanne S. [1 ]
Dooley, Kelly E. [5 ]
Mirochnick, Mark [6 ]
机构
[1] Johns Hopkins Univ, Sch Med, Dept Gynecol & Obstet, Div Maternal Fetal Med & Clin Pharmacol, 600 N Wolfe St, Baltimore, MD 21287 USA
[2] Johns Hopkins Univ, Sch Publ Hlth, Grad Training Program Clin Invest GTPCI, Doctoral Training Program Phd, Baltimore, MD USA
[3] Univ Colorado, Dept Pharmaceut Sci, Anschutz Med Campus, Aurora, CO USA
[4] Addis Ababa Univ, Coll Hlth Sci, Dept Obstet & Gynecol, Addis Ababa, Ethiopia
[5] Johns Hopkins Univ, Sch Med, Dept Med, Div Clin Pharmacol & Infect Dis, Baltimore, MD 21205 USA
[6] Boston Univ, Sch Med, Dept Pediat, Div Neonatol, Boston, MA 02118 USA
关键词
Tenofovir Alafenamide (TAF); pregnancy; postpartum; Human Immunodeficiency Virus (HIV); TRANSCRIPTASE INHIBITOR TENOFOVIR; DRIED BLOOD SPOTS; DISOPROXIL FUMARATE; ANTIRETROVIRAL THERAPY; INTRACELLULAR ACTIVATION; PREEXPOSURE PROPHYLAXIS; ANTIVIRAL ACTIVITY; SUPPRESSED ADULTS; DOUBLE-BLIND; CATHEPSIN-A;
D O I
10.1080/17425255.2020.1738384
中图分类号
Q5 [生物化学]; Q7 [分子生物学];
学科分类号
071010 ; 081704 ;
摘要
Introduction: Tenofovir alafenamide (TAF)-containing fixed-dose drug combinations (FDCs) are increasingly being used in managing pregnant women living with HIV. However, TAF is not currently recommended during pregnancy due to limited pharmacokinetic and safety data. TAF, a newer nucleotide phosphonamidate prodrug of tenofovir (TFV), achieves high levels of tenofovir-diphosphate in lymphoid cells and hepatocytes, and 90% lower systemic concentrations of TFV compared to tenofovir disoproxil fumarate (TDF), thereby maximizing TAF's antiviral efficacy, potency and clinical safety. Areas covered: This review discusses the currently available information on the pharmacology of TAF in pregnant women living with HIV. Pharmacokinetic studies with TAF during pregnancy have yielded varying results compared to postpartum, but TAF exposures during pregnancy have been within the range of those typically observed in non-pregnant adults. The efficacy and safety of TAF in treatment-naive pregnant women living with HIV is currently being evaluated in the VESTED study, a phase-III NIH randomized clinical trial. Expert opinion: Initial pregnancy data suggest that TAF-based FDCs have high efficacy and low risk of adverse effects during pregnancy. TAF is likely to become part of first-line regimens for use in pregnant women living with HIV once additional pregnancy data from phase III trials are available.
引用
收藏
页码:333 / 342
页数:10
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