Cargando…
Kinetics and Determining Factors of the Virologic Response to Antiretrovirals during Pregnancy
HIV-infected pregnant women with undetectable plasma HIV RNA concentrations at delivery pose a minimal risk of vertical transmission. We studied the kinetics and the determinants of the virologic response to antiretroviral therapy in 117 consecutive pregnancies. Patients who initiated therapy during...
Autores principales: | , , , , , , , , , , , , |
---|---|
Formato: | Texto |
Lenguaje: | English |
Publicado: |
Hindawi Publishing Corporation
2009
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2814231/ https://www.ncbi.nlm.nih.gov/pubmed/20130816 http://dx.doi.org/10.1155/2009/621780 |
_version_ | 1782176988155346944 |
---|---|
author | Weinberg, Adriana Harwood, Jeri E. F. McFarland, Elizabeth J. Pappas, Jennifer Davies, Jill Kinzie, Kay Barr, Emily Paul, Suzanne Salbenblatt, Carol Soda, Elizabeth Vazquez, Anna Peloquin, Charles A. Levin, Myron J. |
author_facet | Weinberg, Adriana Harwood, Jeri E. F. McFarland, Elizabeth J. Pappas, Jennifer Davies, Jill Kinzie, Kay Barr, Emily Paul, Suzanne Salbenblatt, Carol Soda, Elizabeth Vazquez, Anna Peloquin, Charles A. Levin, Myron J. |
author_sort | Weinberg, Adriana |
collection | PubMed |
description | HIV-infected pregnant women with undetectable plasma HIV RNA concentrations at delivery pose a minimal risk of vertical transmission. We studied the kinetics and the determinants of the virologic response to antiretroviral therapy in 117 consecutive pregnancies. Patients who initiated therapy during pregnancy had a VL decrease of 2 and 2.5 log(10) after 4 and 24 weeks, respectively. Therapeutic drug monitoring (TDM) of the protease inhibitors administered in doses recommended for nonpregnant adults resulted in below-target concentrations in 29%, 35%, and 44% of 1st, 2nd, and 3rd trimester measurements, respectively, but low drug concentrations did not correlate with virologic failure. Demographic characteristics, antiretroviral experience prior to pregnancy, baseline VL, or use of specific antiretrovirals did not affect the virologic response. Adherence to ≥95% of prescribed doses and utilization of psychosocial services were associated with undetectable plasma HIV RNA at delivery. In conclusion, the virologic responses of pregnant and nonpregnant adults share similar charactersitics. |
format | Text |
id | pubmed-2814231 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2009 |
publisher | Hindawi Publishing Corporation |
record_format | MEDLINE/PubMed |
spelling | pubmed-28142312010-02-03 Kinetics and Determining Factors of the Virologic Response to Antiretrovirals during Pregnancy Weinberg, Adriana Harwood, Jeri E. F. McFarland, Elizabeth J. Pappas, Jennifer Davies, Jill Kinzie, Kay Barr, Emily Paul, Suzanne Salbenblatt, Carol Soda, Elizabeth Vazquez, Anna Peloquin, Charles A. Levin, Myron J. Infect Dis Obstet Gynecol Clinical Study HIV-infected pregnant women with undetectable plasma HIV RNA concentrations at delivery pose a minimal risk of vertical transmission. We studied the kinetics and the determinants of the virologic response to antiretroviral therapy in 117 consecutive pregnancies. Patients who initiated therapy during pregnancy had a VL decrease of 2 and 2.5 log(10) after 4 and 24 weeks, respectively. Therapeutic drug monitoring (TDM) of the protease inhibitors administered in doses recommended for nonpregnant adults resulted in below-target concentrations in 29%, 35%, and 44% of 1st, 2nd, and 3rd trimester measurements, respectively, but low drug concentrations did not correlate with virologic failure. Demographic characteristics, antiretroviral experience prior to pregnancy, baseline VL, or use of specific antiretrovirals did not affect the virologic response. Adherence to ≥95% of prescribed doses and utilization of psychosocial services were associated with undetectable plasma HIV RNA at delivery. In conclusion, the virologic responses of pregnant and nonpregnant adults share similar charactersitics. Hindawi Publishing Corporation 2009 2010-01-10 /pmc/articles/PMC2814231/ /pubmed/20130816 http://dx.doi.org/10.1155/2009/621780 Text en Copyright © 2009 Adriana Weinberg et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Clinical Study Weinberg, Adriana Harwood, Jeri E. F. McFarland, Elizabeth J. Pappas, Jennifer Davies, Jill Kinzie, Kay Barr, Emily Paul, Suzanne Salbenblatt, Carol Soda, Elizabeth Vazquez, Anna Peloquin, Charles A. Levin, Myron J. Kinetics and Determining Factors of the Virologic Response to Antiretrovirals during Pregnancy |
title | Kinetics and Determining Factors of the Virologic Response to Antiretrovirals during Pregnancy |
title_full | Kinetics and Determining Factors of the Virologic Response to Antiretrovirals during Pregnancy |
title_fullStr | Kinetics and Determining Factors of the Virologic Response to Antiretrovirals during Pregnancy |
title_full_unstemmed | Kinetics and Determining Factors of the Virologic Response to Antiretrovirals during Pregnancy |
title_short | Kinetics and Determining Factors of the Virologic Response to Antiretrovirals during Pregnancy |
title_sort | kinetics and determining factors of the virologic response to antiretrovirals during pregnancy |
topic | Clinical Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2814231/ https://www.ncbi.nlm.nih.gov/pubmed/20130816 http://dx.doi.org/10.1155/2009/621780 |
work_keys_str_mv | AT weinbergadriana kineticsanddeterminingfactorsofthevirologicresponsetoantiretroviralsduringpregnancy AT harwoodjerief kineticsanddeterminingfactorsofthevirologicresponsetoantiretroviralsduringpregnancy AT mcfarlandelizabethj kineticsanddeterminingfactorsofthevirologicresponsetoantiretroviralsduringpregnancy AT pappasjennifer kineticsanddeterminingfactorsofthevirologicresponsetoantiretroviralsduringpregnancy AT daviesjill kineticsanddeterminingfactorsofthevirologicresponsetoantiretroviralsduringpregnancy AT kinziekay kineticsanddeterminingfactorsofthevirologicresponsetoantiretroviralsduringpregnancy AT barremily kineticsanddeterminingfactorsofthevirologicresponsetoantiretroviralsduringpregnancy AT paulsuzanne kineticsanddeterminingfactorsofthevirologicresponsetoantiretroviralsduringpregnancy AT salbenblattcarol kineticsanddeterminingfactorsofthevirologicresponsetoantiretroviralsduringpregnancy AT sodaelizabeth kineticsanddeterminingfactorsofthevirologicresponsetoantiretroviralsduringpregnancy AT vazquezanna kineticsanddeterminingfactorsofthevirologicresponsetoantiretroviralsduringpregnancy AT peloquincharlesa kineticsanddeterminingfactorsofthevirologicresponsetoantiretroviralsduringpregnancy AT levinmyronj kineticsanddeterminingfactorsofthevirologicresponsetoantiretroviralsduringpregnancy |