Maternal Lopinavir/Ritonavir Is Associated with Fewer Adverse Events in Infants than Nelfinavir or Atazanavir

Autor: Jeri E. Forster, Myron J. Levin, Jennifer Pappas, Elizabeth J. McFarland, Suzanne Paul, Emily Barr, Jill K. Davies, Adriana Weinberg, Christiana Smith, Kay Kinzie
Jazyk: angličtina
Rok vydání: 2016
Předmět:
Male
0301 basic medicine
Lopinavir/ritonavir
Pharmacology
Gastroenterology
Infant
Newborn
Diseases
Lopinavir
0302 clinical medicine
Pregnancy
immune system diseases
030212 general & internal medicine
Pregnancy Complications
Infectious
education.field_of_study
Nelfinavir
Obstetrics and Gynecology
Lamivudine
virus diseases
3. Good health
Infectious Diseases
Prenatal Exposure Delayed Effects
Drug Therapy
Combination
Female
Research Article
medicine.drug
medicine.medical_specialty
Article Subject
Atazanavir Sulfate
Population
Dermatology
lcsh:Gynecology and obstetrics
lcsh:Infectious and parasitic diseases
03 medical and health sciences
Zidovudine
Internal medicine
medicine
Humans
lcsh:RC109-216
education
lcsh:RG1-991
Retrospective Studies
Ritonavir
business.industry
Infant
Newborn
HIV Protease Inhibitors
030112 virology
Atazanavir
business
Zdroj: Infectious Diseases in Obstetrics and Gynecology, Vol 2016 (2016)
Infectious Diseases in Obstetrics and Gynecology
ISSN: 1098-0997
1064-7449
Popis: Combination antiretroviral therapy (cART) is successfully used for prevention of perinatal HIV transmission. To investigate safety, we compared adverse events (AE) among infants exposed to different maternal cART regimens. We reviewed 158 HIV-uninfected infants born between 1997 and 2009, using logistic regression to model grade ≥1 AE and grade ≥3 AE as a function of maternal cART and confounding variables (preterm, C-section, illicit drug use, race, ethnicity, infant antiretrovirals, and maternal viremia). Frequently used cART regimens included zidovudine (63%), lamivudine (80%), ritonavir-boosted lopinavir (37%), nelfinavir (26%), and atazanavir (10%). At birth, anemia occurred in 13/140 infants (9%), neutropenia in 27/107 (25%), thrombocytopenia in 5/133 (4%), and liver enzyme elevation in 21/130 (16%). Corresponding rates of AE at 4 weeks were 59/141 (42%), 54/130 (42%), 3/137 (2%), and 3/104 (3%), respectively. Serious AE (grade ≥ 3) exceeded 2% only for neutropenia (13% at birth; 9% at 4 weeks). Compared with infants exposed to maternal lopinavir/ritonavir, infants exposed to nelfinavir and atazanavir had a 5-fold and 4-fold higher incidence of AE at birth, respectively. In conclusion, hematologic and hepatic AE were frequent, but rarely serious. In this predominantly protease inhibitor-treated population, lopinavir/ritonavir was associated with the lowest rate of infant AE.
Databáze: OpenAIRE
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