Atazanavir in pregnancy: impact on neonatal hyperbilirubinemia
| Autor: | Evelyne Herinomenzanahary, Françoise Meier, Claudia Ferreira, Corinne Floch-Tudal, Jean-Marc Tréluyer, Elie Azria, Laurent Mandelbrot, Gilles Peytavin, Fabienne Mazy, Catherine Crenn-Hebert |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Pyridines Bilirubin Atazanavir Sulfate HIV Infections Medical Records Cohort Studies chemistry.chemical_compound Acquired immunodeficiency syndrome (AIDS) Pregnancy Antiretroviral Therapy Highly Active medicine Humans Pregnancy Complications Infectious Maternal-Fetal Exchange Retrospective Studies Fetus Ritonavir business.industry Infant Newborn virus diseases Obstetrics and Gynecology Transplacental HIV Protease Inhibitors Phototherapy Fetal Blood medicine.disease Jaundice Neonatal Atazanavir Surgery Reproductive Medicine chemistry Prenatal Exposure Delayed Effects Gestation Female Hyperbilirubinemia Neonatal business Oligopeptides human activities medicine.drug |
| Zdroj: | European Journal of Obstetrics & Gynecology and Reproductive Biology. 157:18-21 |
| ISSN: | 0301-2115 |
| Popis: | To study the impact on the neonate of maternal antiretroviral therapy with atazanavir (ATV).An observational study of 22 HIV-infected women receiving, for clinical indications, antiretroviral therapy with ATV 300 mg and ritonavir 100mg during pregnancy and their 23 HIV infants (including a twin pair).Mothers had received ATV for a median duration of 19 months [range 3-49] by delivery. At delivery, plasma HIV-RNA was40 copies/mL in all patients. Liver enzymes were normal in 19/22 patients, but one woman had grade 3-4 liver toxicity. Maternal serum bilirubin concentrations were above the upper limit of normal in most patients, with grade 3 toxicity in 5 patients. All but one woman had trough ATV concentrations during pregnancy above the minimum effective concentration. The median cord blood ATV concentration was 130 ng/mL [range30-758]; the cord/maternal ratio was 21%. All neonates were born at term [median 38.2 weeks]. Three neonates had mildly elevated AST transaminase levels. Bilirubin concentrations at birth were significantly higher than maternal concentrations, with a median of 44 μm/L [range 24-129]; values on days 2-3 were 63 [8-212]. Five neonates had jaundice requiring phototherapy, without liver damage, and recovered without sequelae.Neonates whose mothers were treated with ATV should be monitored for hyperbilirubinemia, which may be due to placental transfer of unconjugated bilirubin from the mother and/or a direct effect of transplacental ATV on bilirubin metabolism in the fetus. |
| Databáze: | OpenAIRE |
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