Therapeutic drug monitoring (TDM) of atazanavir in pregnancy
نویسندگان
چکیده
Methods In this prospective, open labelled study, pregnant HIVpositive women received ATV/r as part of their routine pre-natal care. Demographic and clinical data were collected, and ATV plasma concentrations [ATV] were determined in the first (T1) and/or second (T2) and/or third (T3) trimester using HPLC-MS/MS (LLQ = 0.05 μg/mL). Postpartum (PP) sampling was performed where applicable. Antepartum (AP) and PP PK parameters were compared using a One-way ANOVA (for independent data sets) and a paired t-test (for paired data). Summary of results From January 2007 31 women (25 black African) were enrolled in the study. All received ATV/r at standard dose of 1 tablet once daily (300/100 mg od). 10/31 women initiated ATV/r treatment during pregnancy. Median (range) gestation at initiation in these patients was 24 weeks (7-35). Median (range) baseline CD4 count was 393 cells/μL (153-869) and 17 patients had a baseline plasma viral load of < 50 copies/mL. [ATV] were determined in 10/31 (T1); 17/31 (T2); 27/31 (T3) and 21/31 (PP) patients. Time of TDM sampling and [ATV] (geometric mean; 95%CI) are given in the Table. 2/17 patients at T2, 2/27 (T3) and 2/21 at PP had concentrations <LLQ (suggesting non-adherence). [ATV] were lower AP relative to that observed at PP (Table 1). Equally, in a paired analysis of 17 patients (T3 vs. PP), [ATV] were significantly reduced at T3 (P=0.0005).
منابع مشابه
The use of TDM in pregnant HIV-positive women: a retrospective cross-sectional review of five years practice in two large hospitals in Manchester
INTRODUCTION Despite plasma levels of certain HIV drugs decreasing in the third trimester of pregnancy there is no definitive evidence that therapeutic drug monitoring (TDM) improves HIV control and prevents mother-to-child transmission (MTCT). Indeed "one-off" TDM measurements are thought to poorly correlate with overall drug exposure [1]. We aim to describe baseline demographic and clinical c...
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