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Review article: direct‐acting antivirals for the treatment of HCV during pregnancy and lactation ‐ implications for maternal dosing, foetal exposure, and safety for mother and child

BACKGROUND: With the global efforts to eradicate hepatitis C virus (HCV), treatment during pregnancy is becoming a priority for research as this, and maternal cure should reduce vertical transmission. However, as information on the efficacy and safety of direct‐acting antivirals (DAAs) in pregnancy...

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Autores principales: Freriksen, Jolien J. M., van Seyen, Minou, Judd, Ali, Gibb, Diana M., Collins, Intira J., Greupink, Rick, Russel, Frans G. M., Drenth, Joost P. H., Colbers, Angela, Burger, David M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6773363/
https://www.ncbi.nlm.nih.gov/pubmed/31448450
http://dx.doi.org/10.1111/apt.15476
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author Freriksen, Jolien J. M.
van Seyen, Minou
Judd, Ali
Gibb, Diana M.
Collins, Intira J.
Greupink, Rick
Russel, Frans G. M.
Drenth, Joost P. H.
Colbers, Angela
Burger, David M.
author_facet Freriksen, Jolien J. M.
van Seyen, Minou
Judd, Ali
Gibb, Diana M.
Collins, Intira J.
Greupink, Rick
Russel, Frans G. M.
Drenth, Joost P. H.
Colbers, Angela
Burger, David M.
author_sort Freriksen, Jolien J. M.
collection PubMed
description BACKGROUND: With the global efforts to eradicate hepatitis C virus (HCV), treatment during pregnancy is becoming a priority for research as this, and maternal cure should reduce vertical transmission. However, as information on the efficacy and safety of direct‐acting antivirals (DAAs) in pregnancy is generally lacking, treatment of HCV infection during pregnancy is not currently recommended. AIM: To provide an overview of current knowledge regarding maternal exposure, placental handling and safety of DAAs during pregnancy and lactation METHODS: A literature search was performed focusing on the effect of pregnancy on maternal exposure to DAAs, the placental handling of DAAs, the safety of DAAs for mother and child during pregnancy and the safety of DAAs during lactation. RESULTS: Exposure to all DAAs studied is likely to be altered during pregnancy, mostly related to pregnancy‐induced effects on drug absorption and metabolism. Although animal studies show that most DAAs are reported to cross the placenta and transfer into breast milk, most DAA combinations show a favourable safety profile. Because of the rapid viral decline after treatment initiation, and to avoid the critical period of organogenesis, treatment may be started at the end of the second trimester or early third trimester. CONCLUSIONS: Treatment of HCV infection during pregnancy is realistic, as DAAs are highly effective and treatment duration is relatively short. There is an urgent need to study DAAs during pregnancy and lactation to contribute to the goal of HCV elimination.
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spelling pubmed-67733632019-10-07 Review article: direct‐acting antivirals for the treatment of HCV during pregnancy and lactation ‐ implications for maternal dosing, foetal exposure, and safety for mother and child Freriksen, Jolien J. M. van Seyen, Minou Judd, Ali Gibb, Diana M. Collins, Intira J. Greupink, Rick Russel, Frans G. M. Drenth, Joost P. H. Colbers, Angela Burger, David M. Aliment Pharmacol Ther Review Articles BACKGROUND: With the global efforts to eradicate hepatitis C virus (HCV), treatment during pregnancy is becoming a priority for research as this, and maternal cure should reduce vertical transmission. However, as information on the efficacy and safety of direct‐acting antivirals (DAAs) in pregnancy is generally lacking, treatment of HCV infection during pregnancy is not currently recommended. AIM: To provide an overview of current knowledge regarding maternal exposure, placental handling and safety of DAAs during pregnancy and lactation METHODS: A literature search was performed focusing on the effect of pregnancy on maternal exposure to DAAs, the placental handling of DAAs, the safety of DAAs for mother and child during pregnancy and the safety of DAAs during lactation. RESULTS: Exposure to all DAAs studied is likely to be altered during pregnancy, mostly related to pregnancy‐induced effects on drug absorption and metabolism. Although animal studies show that most DAAs are reported to cross the placenta and transfer into breast milk, most DAA combinations show a favourable safety profile. Because of the rapid viral decline after treatment initiation, and to avoid the critical period of organogenesis, treatment may be started at the end of the second trimester or early third trimester. CONCLUSIONS: Treatment of HCV infection during pregnancy is realistic, as DAAs are highly effective and treatment duration is relatively short. There is an urgent need to study DAAs during pregnancy and lactation to contribute to the goal of HCV elimination. John Wiley and Sons Inc. 2019-08-25 2019-10 /pmc/articles/PMC6773363/ /pubmed/31448450 http://dx.doi.org/10.1111/apt.15476 Text en © 2019 The Authors. Alimentary Pharmacology & Therapeutics published by John Wiley & Sons Ltd This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Review Articles
Freriksen, Jolien J. M.
van Seyen, Minou
Judd, Ali
Gibb, Diana M.
Collins, Intira J.
Greupink, Rick
Russel, Frans G. M.
Drenth, Joost P. H.
Colbers, Angela
Burger, David M.
Review article: direct‐acting antivirals for the treatment of HCV during pregnancy and lactation ‐ implications for maternal dosing, foetal exposure, and safety for mother and child
title Review article: direct‐acting antivirals for the treatment of HCV during pregnancy and lactation ‐ implications for maternal dosing, foetal exposure, and safety for mother and child
title_full Review article: direct‐acting antivirals for the treatment of HCV during pregnancy and lactation ‐ implications for maternal dosing, foetal exposure, and safety for mother and child
title_fullStr Review article: direct‐acting antivirals for the treatment of HCV during pregnancy and lactation ‐ implications for maternal dosing, foetal exposure, and safety for mother and child
title_full_unstemmed Review article: direct‐acting antivirals for the treatment of HCV during pregnancy and lactation ‐ implications for maternal dosing, foetal exposure, and safety for mother and child
title_short Review article: direct‐acting antivirals for the treatment of HCV during pregnancy and lactation ‐ implications for maternal dosing, foetal exposure, and safety for mother and child
title_sort review article: direct‐acting antivirals for the treatment of hcv during pregnancy and lactation ‐ implications for maternal dosing, foetal exposure, and safety for mother and child
topic Review Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6773363/
https://www.ncbi.nlm.nih.gov/pubmed/31448450
http://dx.doi.org/10.1111/apt.15476
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