BACKGROUND: No pharmacokinetic data exist for premature infants receiving single-dosenevirapine (sd NVP) for prevention of mother-to-child transmission (MTCT) of HIV. AIM: To describe NVP decay pharmacokinetics in two groups of premature infants - those whose mothers either received or did not receive NVP during labour. METHODS:Infants less than 37 weeks' gestation were prospectively enrolled. Mothers received sd NVP during labour. Infants received sd NVP and zidovudine. Blood was collected on specified days after birth and NVP concentrations were determined by liquid chromatography-mass spectrometry. RESULTS: Data were obtained from 81 infants, 58 born to mothers who received sd NVP during labour (group I) and 23 to mothers who did not receiveNVP (group II). Of the infants 29.6% were small for gestational age (SGA). Median (range) maximum concentration (Cmax), time to reach maximum concentration (Tmax), area under the plasma concentration-time curve (AUC) and half-life (T½) were 1 438 (350 - 3 832) ng/ml, 25h50 (9h40 - 83h45), 174 134 (22 308 - 546 408) ng/h/ml and 59.0 (15.4 - 532.6) hours for group I and 1 535 (635 - 4 218) ng/ml, 17h35 (7h40 - 29h), 168 576 (20 268 - 476 712) ng/h/ml and 69.0 (22.12 - 172.3) hours for group II. For group II, the median (range) volume of distribution (Vd) and body clearance (Cl) were 1 702.6 (623.7 - 6 189.8) ml and 34.9 (6.2 - 163.8) ml/h. The AUC was higher (p=0.006) and Cl lower (p<0.0001) in SGA infants. Plasma concentrations exceeding 100ng/ml were achieved over 8 days in 78% infants in group I and 70.0% in group II. The MTCT rate was 4.8%. CONCLUSION: Women in preterm labour often deliver with little advance warning. Our study suggests that NVP dosing of preterm infants as soon as possible after birth without maternal intrapartum dosing may be as effective as combined maternal and infant dosing.
RCT Entities:
BACKGROUND: No pharmacokinetic data exist for premature infants receiving single-dose nevirapine (sd NVP) for prevention of mother-to-child transmission (MTCT) of HIV. AIM: To describe NVP decay pharmacokinetics in two groups of premature infants - those whose mothers either received or did not receive NVP during labour. METHODS:Infants less than 37 weeks' gestation were prospectively enrolled. Mothers received sd NVP during labour. Infants received sd NVP and zidovudine. Blood was collected on specified days after birth and NVP concentrations were determined by liquid chromatography-mass spectrometry. RESULTS: Data were obtained from 81 infants, 58 born to mothers who received sd NVP during labour (group I) and 23 to mothers who did not receive NVP (group II). Of the infants 29.6% were small for gestational age (SGA). Median (range) maximum concentration (Cmax), time to reach maximum concentration (Tmax), area under the plasma concentration-time curve (AUC) and half-life (T½) were 1 438 (350 - 3 832) ng/ml, 25h50 (9h40 - 83h45), 174 134 (22 308 - 546 408) ng/h/ml and 59.0 (15.4 - 532.6) hours for group I and 1 535 (635 - 4 218) ng/ml, 17h35 (7h40 - 29h), 168 576 (20 268 - 476 712) ng/h/ml and 69.0 (22.12 - 172.3) hours for group II. For group II, the median (range) volume of distribution (Vd) and body clearance (Cl) were 1 702.6 (623.7 - 6 189.8) ml and 34.9 (6.2 - 163.8) ml/h. The AUC was higher (p=0.006) and Cl lower (p<0.0001) in SGA infants. Plasma concentrations exceeding 100ng/ml were achieved over 8 days in 78% infants in group I and 70.0% in group II. The MTCT rate was 4.8%. CONCLUSION:Women in preterm labour often deliver with little advance warning. Our study suggests that NVP dosing of preterm infants as soon as possible after birth without maternal intrapartum dosing may be as effective as combined maternal and infant dosing.
Authors: Alexander P Dahinten; Dorothy E Dow; Coleen K Cunningham; Levina J Msuya; Blandina T Mmbaga; Robert A Malkin Journal: Pediatr Infect Dis J Date: 2016-09 Impact factor: 2.129
Authors: Aline G J Engbers; Robert B Flint; Swantje Völler; Johan C A de Klerk; Irwin K M Reiss; Peter Andriessen; Kian D Liem; Pieter L J Degraeuwe; Siska Croubels; Joske Millecam; Karel Allegaert; Sinno H P Simons; Catherijne A J Knibbe Journal: Br J Clin Pharmacol Date: 2020-04-20 Impact factor: 4.335
Authors: Mark F Cotton; Sandi Holgate; Aurelie Nelson; Helena Rabie; Catherine Wedderburn; Mark Mirochnick Journal: J Int AIDS Soc Date: 2015-12-02 Impact factor: 5.396
Authors: Heun Choi; Moo Hyun Kim; Se Ju Lee; Eun Jin Kim; Woonji Lee; Wooyong Jeong; In Young Jung; Jin Young Ahn; Su Jin Jeong; Nam Su Ku; Ji Hyeon Baek; Young Hwa Choi; Hyo Youl Kim; June Myung Kim; Jun Yong Choi Journal: J Korean Med Sci Date: 2018-10-25 Impact factor: 2.153