RESUMO
OBJECTIVE: The purpose of this study was to complete an evaluation of nevirapine (NVP) toxicity in a cohort of HIV+ pregnant women. STUDY DESIGN: This was a retrospective study of 611 women followed from January 1996 to December 2003. All women who used NVP for > 7 days were included. Multivariate logistic regression was used to test independent association of CD4 and hepatitis C virus (HCV) infection related to the outcome of toxic effects of NVP. RESULTS: One hundred ninety-seven women were exposed to NVP for > 7 days, and toxicity occurred in 11 (5.6%), leading to drug discontinuation in 7 patients. One case of Stevens-Johnson syndrome occurred. No serious liver toxicity occurred except for 1 grade 4 cholestasis. Median CD4 was 344 in women without toxicities and 298 in women with toxicities. HCV was the only significant factor associated to toxicity by logistic regression (odds ratio [OR] 15.61, P = .001). CONCLUSION: NVP toxicities occurred in a very small fraction of patients and were not associated with fatalities.
Assuntos
Fármacos Anti-HIV/efeitos adversos , Infecções por HIV/tratamento farmacológico , Nevirapina/efeitos adversos , Complicações Infecciosas na Gravidez/tratamento farmacológico , Adulto , Fármacos Anti-HIV/sangue , Fármacos Anti-HIV/uso terapêutico , Contagem de Linfócito CD4 , Colestase/induzido quimicamente , Estudos de Coortes , Feminino , Infecções por HIV/sangue , Infecções por HIV/complicações , Hepatite B/complicações , Hepatite C/complicações , Humanos , Nevirapina/uso terapêutico , Gravidez , Estudos Retrospectivos , Síndrome de Stevens-Johnson/induzido quimicamenteRESUMO
A cohort of 297 HIV-infected pregnant women was followed from January 1996 to December 2001. The overall transmission rate was 3.57% and remained constant over time. Low birth-weight was independently associated with a higher risk of vertical transmission (P=0.0072), whereas a longer duration of antiretroviral drugs during pregnancy was independently associated with a lower risk of transmission (P=0.0084). Further decreases in transmission should be obtained by initiating prophylaxis earlier in pregnancy.