Metabolic implications and safety of dolutegravir use in pregnancy.


Journal

The lancet. HIV
ISSN: 2352-3018
Titre abrégé: Lancet HIV
Pays: Netherlands
ID NLM: 101645355

Informations de publication

Date de publication:
09 2023
Historique:
received: 28 11 2022
revised: 05 06 2023
accepted: 09 06 2023
medline: 5 9 2023
pubmed: 8 8 2023
entrez: 7 8 2023
Statut: ppublish

Résumé

Dolutegravir is recommended for all people living with HIV because of its efficacy, high barrier to resistance, favourable safety and tolerability profile, and affordability. Dolutegravir has the highest rates of viral suppression in pregnancy, therefore preventing perinatal HIV transmission. In view of these benefits, particularly for pregnant women, an important question is if dolutegravir is safe in pregnancy. Dolutegravir has been associated with metabolic complications, including weight gain and rare events of hyperglycaemia, that could affect maternal, fetal, and postnatal health. We review the current clinically and experimentally based literature on the implications of dolutegravir use for pregnant women and for developing embryos and fetuses. Possible effects on folate status, energy metabolism, adipogenesis, and oxidative stress are considered. In many instances, insufficient data are available, pointing to the need for additional research in this important area of HIV treatment.

Identifiants

pubmed: 37549681
pii: S2352-3018(23)00141-8
doi: 10.1016/S2352-3018(23)00141-8
pii:
doi:

Substances chimiques

dolutegravir DKO1W9H7M1
Oxazines 0
Heterocyclic Compounds, 3-Ring 0
Piperazines 0

Types de publication

Journal Article Review Research Support, N.I.H., Extramural

Langues

eng

Sous-ensembles de citation

IM

Pagination

e606-e616

Subventions

Organisme : NICHD NIH HHS
ID : R01 HD104553
Pays : United States

Informations de copyright

Copyright © 2023 Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of interests We declare no competing interests.

Auteurs

Valeriya Dontsova (V)

Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada.

Haneesha Mohan (H)

Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada.

Camille Blanco (C)

Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada.

Jennifer Jao (J)

Department of Pediatrics, Division of Pediatric Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

Nicholas D E Greene (NDE)

Developmental Biology and Cancer Department, UCL Great Ormond Street Institute of Child Health, University College London, London, UK.

Andrew J Copp (AJ)

Developmental Biology and Cancer Department, UCL Great Ormond Street Institute of Child Health, University College London, London, UK.

Rebecca Zash (R)

Department of Medicine, Division of Infectious Disease, Beth Israel Deaconess Medical Center, Boston, USA.

Lena Serghides (L)

Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada; Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada; Department of Immunology and Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada. Electronic address: lena.serghides@utoronto.ca.

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Classifications MeSH