Preview

Regulatory Research and Medicine Evaluation

Advanced search

Clinical pharmacology aspects of drugs for hiv-infected pregnant women

Abstract

The article summarises literature data on clinical management of HIV infection in pregnant women. It discusses the general principles of antiretroviral therapy for HIV-infected pregnant women and prevention of mother-to-child transmission of HIV infection. It also describes pharmacokinetic properties of antiretroviral drugs for pregnant women. The article highlights issues concerning the effects of pregnancy on drug metabolism, patterns of drug interaction with both ABC and SCL drug transporters and associated clinical implications for antiretroviral therapy. The authors demonstrate the need for therapeutic drug monitoring of protease inhibitors in HIV-infected pregnant women.

About the Authors

E. A. Sokova
Scientific Centre for Expert Evaluation of Medicinal Products
Russian Federation


I. A. Mazerkina
Scientific Centre for Expert Evaluation of Medicinal Products
Russian Federation


O. A. Demidova
Scientific Centre for Expert Evaluation of Medicinal Products
Russian Federation


T. V. Aleksandrova
Scientific Centre for Expert Evaluation of Medicinal Products
Russian Federation


References

1. Darak S, Parchure R, Darak T, Talavlikar R, Kulkarni S, Kulkarni V. Advances in the prevention of mother-to-child transmission of HIV and resulting clinical and programmatic implications. Research and Reports in Neonatology 2014; 4: 111–23.

2. Roustit M, Jlaiel M, Leclercq P, Stanke-Labesque F. Pharmacokinetics and therapeutic drug monitoring of antiretrovirals in pregnant women. Br J Clin Pharmacol. 2008; 66(2): 179–95.

3. Sokova EA, Chilova RA, Proklova GF, Meksha YuV, Demidova OA. The characteristics of drug metabolism during pregnancy. The Bulletin of Contemporary Clinical Medicine 2016; 9(5): 70–5 (in Russian).

4. Mattison DR. Clinical pharmacology during pregnancy. Amsterdam: Elsevier; 2013.

5. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. Department of Health and Human Services [Internet]. 2016 [cited 2017 Jul 10]. Available from: https://goo.gl/RpJPfc.

6. Lundgren JD, Babiker AG, Gordin F, Emery S, Grund B, Sharma S, et al. Initiation of antiretroviral therapy in early asymptomatic HIV Infection.¹ Engl J Med. 2015; 373(9): 795–807.

7. Recommendations for use of antiretroviral drugs in pregnant HIV-1-infected women for maternal health and interventions to reduce perinatal HIV transmission in the United States [Internet]. 2016 [cited 2017 Jul 10]. Available from: https://goo.gl/5VKzKy.

8. Zhuravleva EO, Velts NYu, Zatolochina KE, Glagolev SV, Polivanov VA, Darmostukova MA, et al. Analysis of spontaneous reports of adverse reactions, developed in the use of drugs during pregnancy. Safety and Risk of Pharmacotherapy 2017; 5(2): 61–69 (in Russian).

9. The use of antiretroviral drugs as part of a set of measures aimed at preventing the transmission of HIV from mother to child. Clinical recommendations (protocol of treatment) of the Ministry of Health of the Russian Federation. Available from: http://minzdrav.midural.ru/uploads/1120%D0%B0.pdf (in Russian).

10. Schaefer C, Spielmann H, Vetter K. Drug therapy during pregnancy and lactation. Moscow: Logosfera; 2010 (in Russian).

11. Best B, Stek A, Hu C, Burchett SK, Rossi SS, Smith E, et al. High-dose Lopinavir and standard dose emtricitabine pharmacokinetics during pregnancy and postpartum. 15th Conference on Retroviruses and Opportunistic Infections, February 3–6, 2008, Boston, MA, USA.

12. Capparelli EV, Aweeka F, Hitti J, Stek A, Hu C, Burchett SK, et al. Chronic administration of Nevirapine during pregnancy: impact of pregnancy on pharmacokinetics. HIV Med. 2008; 9(4): 214–20.

13. Van der Lugt J, Colbers A, Molto J, Hawkins D, van der Ende M, Vogel M, et al. The pharmacokinetics, safety and efficacy of boosted Saquinavir tablets in HIV type- 1-infected pregnant women. Antivir Ther. 2009; 14(3): 443–50.

14. De Cock KM, Fowler MG, Mercier E, de Vincenzi I, Saba J, Hoff E, et al. Prevention of mother-to-child HIV transmission in resource-poor countries: translating research into policy and practice. JAMA 2000; 283(9): 1175–82.

15. Flynn PM, Mirochnick M, Shapiro DE, Bardeguez A, Rodman J, Robbins B, et al. Pharmacokinetics and safety of single-dose Tenofovir disoproxil fumarate and Emtricitabine in HIV-1-infected pregnant women and their infants. Antimicrob Agents Chemother. 2011; 55(12): 5914–22.

16. Sokova EA. Monitoring post-approval drug safety in pregnancy: pharmacogenetic aspects. Safety and Risk of Pharmacotherapy 2015; (3): 30–35 (in Russian).

17. Gedeon C, Koren G. Designing pregnancy centered medications: drugs which do not cross the human placenta. Placenta 2006; 27(8): 861–8.

18. Sudhakaran S, Rayner CR, Li J, Kong DC, Gude NM, Nation RL. Inhibition of placental P-glycoprotein: impact on indinavir transfer to the foetus. Br J Clin Pharmacol. 2008; 65(5): 667–73.

19. Storch CH, Theile D, Lindenmaier H, Haefeli WE, Weiss J. Comparison of the inhibitory activity of anti-HIV drugs on P-glycoprotein. Biochem Pharmacol. 2007; 73(10): 1573–81.

20. Minuesa G, Volk C, Molina-Arcas M, Gorboulev V, Erkizia I, Arndt P, et al. Transport of lamivudine [(-)-beta-L-2, 3-dideoxy-3-thiacytidine] and high-affinity interaction of nucleoside reverse transcriptase inhibitors with human organic cation transporters 1, 2, and 3. J Pharmacol Exp Ther. 2009; 329(1): 252–61.

21. Weiss J, Rose J, Storch CH, Ketabi-Kiyanvash N, Sauer A, Haefeli WE, Efferth T. Modulation of human BCRP (ABCG2) activity by anti-HIV drugs. J Antimicrob Chemother. 2007; 59(2): 238–45.

22. Gulati A, Gerk PM. Role of placental ATP-binding cassette (ABC) trasporters in antiretroviral therapy during pregnanacy. J Pharm Sci. 2009; 98(7): 2317–35.


Review

For citations:


Sokova E.A., Mazerkina I.A., Demidova O.A., Aleksandrova T.V. Clinical pharmacology aspects of drugs for hiv-infected pregnant women. The Bulletin of the Scientific Centre for Expert Evaluation of Medicinal Products. 2017;7(3):150-154. (In Russ.)

Views: 1153


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 3034-3062 (Print)
ISSN 3034-3453 (Online)