Frequency of differential placental transfer to twins of maternal antiretroviral medications

Autor: Minh Tam Le, Gilles Peytavin, Dominique Luton, Margaux Louchet, Luc Rigonnot, Laurent Mandelbrot, Isabelle Matheron, Hélène Didelot, Lionel Carbillon, Agnès Bourgeois-Moine
Přispěvatelé: Hôpital Louis Mourier - AP-HP [Colombes], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université de Paris (UP), Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Université Sorbonne Paris Nord, AP-HP - Hôpital Bichat - Claude Bernard [Paris], Hôpital Jean Verdier [AP-HP], Centre Hospitalier Intercommunal Villeneuve-Saint-Georges (CHIV), Centre Hospitalier Sud Francilien, CH Evry-Corbeil, CCSD, Accord Elsevier, Université Paris Cité (UPCité), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: European Journal of Obstetrics & Gynecology and Reproductive Biology
European Journal of Obstetrics & Gynecology and Reproductive Biology, Elsevier, 2021, 256, pp.405-411. ⟨10.1016/j.ejogrb.2020.11.004⟩
European Journal of Obstetrics & Gynecology and Reproductive Biology, 2021, 256, pp.405-411. ⟨10.1016/j.ejogrb.2020.11.004⟩
ISSN: 0301-2115
Popis: Background Placental passage of drugs in twins is poorly understood, and is unknown regarding antiretrovirals (ARVs). In the event of large differences in the exposure of 2 twins to the same maternal therapy, this could have a clinical impact in terms of prevention of perinatal HIV transmission or adverse effects. Objective To describe the frequency of differential transplacental passage of antiretrovirals between twins. Study design The study was performed retrospectively, on data from women included in a multicenter perinatal HIV cohort study. All twin pairs for which the mother received antiretroviral therapy and for which drug concentrations in both of the umbilical cords after cord clamping at delivery were studied. We considered that a difference in concentrations of more than 50 % between twins was a substantial difference (ratios below 0.67 or above 1.50). Results We analyzed 29 twin pairs, 27 dichorionic and 2 monochorionic diamniotic. Cord blood concentrations differed between the 2 twins by more than 50 % for at least one ARV in 9 twin pairs, 8 dichorionic and 1 monochorionic. Discordant concentrations were observed in one or more cases for several nucleoside reverse transcriptase inhibitors (tenofovir, emtricitabine, lamivudine, zidovudine) and protease inhibitors (atazanavir, lopinavir, saquinavir et ritonavir); within individual twin pairs placental transfer was discordant for one or more ARVs, but identical for others. Conclusion Concentrations differed in nearly one third of twin pairs. This may be due to interindividual genetic variability of placental transporters between dizygotic twins as well as physiological differences between twins.
Databáze: OpenAIRE
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