BACKGROUND: For some antiretroviral therapies, drug concentrations are reduced during pregnancy, potentially compromising effective virological suppression. METHODS: Data on atazanavir boosted with ritonavir in pregnancy are reviewed. RESULTS: With standard atazanavir/ritonavir 300/100 mg once-daily dosing: atazanavir area-under-the-concentration-time curves were reduced during pregnancy in most studies, but overall interpretation differed according to the data used for comparison; atazanavir concentration 24 h post-dose was maintained >150 ng/ml in 97.6% of women; no instance of mother-to-child transmission occurred in treatment-adherent mothers; and infant hyperbilirubinaemia was not elevated beyond levels expected in the neonatal period. CONCLUSIONS: With concurrent medications that reduce atazanavir drug concentrations, optimal therapy during pregnancy may require once-daily atazanavir/ritonavir 400/100 mg; however, using this dose during the third trimester doubled maternal grade 3-4 hyperbilirubinaemia rates.
BACKGROUND: For some antiretroviral therapies, drug concentrations are reduced during pregnancy, potentially compromising effective virological suppression. METHODS: Data on atazanavir boosted with ritonavir in pregnancy are reviewed. RESULTS: With standard atazanavir/ritonavir 300/100 mg once-daily dosing: atazanavir area-under-the-concentration-time curves were reduced during pregnancy in most studies, but overall interpretation differed according to the data used for comparison; atazanavir concentration 24 h post-dose was maintained >150 ng/ml in 97.6% of women; no instance of mother-to-child transmission occurred in treatment-adherent mothers; and infanthyperbilirubinaemia was not elevated beyond levels expected in the neonatal period. CONCLUSIONS: With concurrent medications that reduce atazanavir drug concentrations, optimal therapy during pregnancy may require once-daily atazanavir/ritonavir 400/100 mg; however, using this dose during the third trimester doubled maternal grade 3-4 hyperbilirubinaemia rates.
Authors: Angela Colbers; Brookie Best; Stein Schalkwijk; Jiajia Wang; Alice Stek; Carmen Hidalgo Tenorio; David Hawkins; Graham Taylor; Regis Kreitchmann; Sandra Burchett; Annette Haberl; Kabamba Kabeya; Marjo van Kasteren; Elizabeth Smith; Edmund Capparelli; David Burger; Mark Mirochnick Journal: Clin Infect Dis Date: 2015-07-22 Impact factor: 9.079
Authors: Regis Kreitchmann; Brookie M Best; Jiajia Wang; Alice Stek; Edmund Caparelli; D Heather Watts; Elizabeth Smith; David E Shapiro; Steve Rossi; Sandra K Burchett; Elizabeth Hawkins; Mark Byroads; Tim R Cressey; Mark Mirochnick Journal: J Acquir Immune Defic Syndr Date: 2013-05-01 Impact factor: 3.731
Authors: Deborah M Money; Emily C Wagner; Evelyn J Maan; Tessa Chaworth-Musters; Izabelle Gadawski; Julie E van Schalkwyk; John C Forbes; David R Burdge; Arianne Y K Albert; Zoe Lohn; Hélène C F Côté Journal: PLoS One Date: 2015-08-06 Impact factor: 3.240