Pharmacokinetics of Antiretroviral Agents in Pregnant Individuals Living With HIV: Current Status and Considerations for Study Design and Interpretation.
HIV
antiretrovirals (ARVs)
pharmacokinetics
postpartum
pregnancy
Journal
Journal of clinical pharmacology
ISSN: 1552-4604
Titre abrégé: J Clin Pharmacol
Pays: England
ID NLM: 0366372
Informations de publication
Date de publication:
06 2023
06 2023
Historique:
received:
10
12
2022
accepted:
23
02
2023
medline:
16
6
2023
pubmed:
15
6
2023
entrez:
15
6
2023
Statut:
ppublish
Résumé
Determining the appropriate dosing regimens of antiretroviral (ARV) drugs for pregnant individuals living with HIV-1 infection is critical to maximize maternal health and prevent perinatal HIV transmission. Throughout pregnancy, pharmacokinetics (PK) of ARVs can be significantly altered due to physiological, anatomic, and metabolic changes. As such, conducting PK studies of ARVs during pregnancy is crucial to optimize dosing regimens. In this article, we summarize available data, key issues, challenges, and considerations in interpreting results of ARV PK studies in pregnant individuals. Discussion topics include the choice of the reference population (postpartum vs historical control), pregnancy trimester-dependent changes in ARV PK, effects of pregnancy on once- versus twice-daily dosing, factors to consider for ARVs that are administered with a PK booster such as ritonavir and cobicistat, and considerations when evaluating the effects of pregnancy on unbound ARV concentrations. Common approaches for the translation of the results into clinical recommendations and rationales and considerations when making clinical recommendations are summarized. Currently, limited PK data in pregnancy are available with long-acting ARVs. Collection of PK data to characterize the PK profile of long-acting ARVs is an important goal shared by many stakeholders.
Substances chimiques
Anti-Retroviral Agents
0
Ritonavir
O3J8G9O825
Cobicistat
LW2E03M5PG
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
S176-S187Informations de copyright
Published 2023. This article is a U.S. Government work and is in the public domain in the USA.
Références
The World Health Organization Estimated Percentage of Pregnant Women Living with HIV Who Received Antiretrovirals for Preventing Mother-to-Child Transmission. Accessed November 11, 2022. https://www.who.int/data/gho/data/indicators/indicator-details/GHO/estimated-percentage-of-pregnant-women-living-with-hiv-who-received-antiretrovirals-for-preventing-mother-to-child-transmission#:∼:text=Globally%2C%20there%20were%201.3%20million,mother%2Dto%2Dchild%20transmission.
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