RESUMO
The use of previously successful antiretroviral regimens in mother-to-child transmission (MTCT) prevention will be increasingly challenged by the rising prevalence of multidrug-resistant (MDR) HIV. We used enfurvitide together with an optimized antiretroviral backbone to prevent the MTCT prevention of MDR HIV in two pregnant women. The measurement of maternal and foetal peripheral blood levels of enfurvitide showed no evidence of transplacental transfer.
Assuntos
Proteína gp41 do Envelope de HIV/uso terapêutico , Infecções por HIV/tratamento farmacológico , HIV-1/efeitos dos fármacos , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Fragmentos de Peptídeos/uso terapêutico , Complicações Infecciosas na Gravidez/tratamento farmacológico , Adulto , Farmacorresistência Viral Múltipla , Enfuvirtida , Feminino , Inibidores da Fusão de HIV/farmacocinética , Inibidores da Fusão de HIV/uso terapêutico , Infecções por HIV/transmissão , Humanos , Troca Materno-Fetal , Fragmentos de Peptídeos/farmacocinética , GravidezRESUMO
The concomitant treatment of HIV-tuberculosis co-infection is complicated by pharmacological interactions between drugs, resulting in unpredictable drug levels. We monitored efavirenz levels in all tuberculosis-HIV-treated patients over 2 years. Using 800 mg/day of efavirenz, high levels and toxicity were detected in seven out of nine patients, necessitating reduction or discontinuation. Polymorphisms in cytochrome P450 2B6 may account for this. Therapeutic drug monitoring, dose reduction or a lower starting dose may be appropriate in some patients to abrogate toxicity.