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3.
Enferm. infecc. microbiol. clín. (Ed. impr.) ; 34(1): 39-44, ene. 2016. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-148504

RESUMO

Introducción: En nuestro medio, el uso de nevirapina en la embarazada infectada por el VIH se desaconseja por su potencial hepatotoxicidad. Existen pocos datos sobre dicha toxicidad en el neonato no infectado por el VIH y expuesto a este fármaco durante la gestación. Se pretende determinar el grado de hepatotoxicidad en el recién nacido expuesto a nevirapina y VIH durante la gestación. Métodos: Estudio transversal observacional multicéntrico en una cohorte de recién nacidos hijos de madre VIH positivas no infectados en los que se revisó la primera determinación de alanina aminotransferasa antes de las 6 semanas de vida. Se establecieron 2 grupos según hubieran estado expuestos o no a nevirapina durante la gestación. La hepatotoxicidad se clasificó según el AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events (DAIDS). Resultados: Se incluyeron 160 recién nacidos de 159 gestaciones (88 expuestos a tratamientos combinados con nevirapina y 71 a inhibidores de proteasa). No se observó ningún caso de hepatotoxicidad según laGrading Table del DAIDS, pero se registraron 2 casos de ALT superior a los valores de normalidad (2,8%, IC 95%: 0,3-9,8) en los no expuestos a nevirapina y uno (1,1%, IC 95%: 0,0-6,1) en el grupo expuesto (p = 0,585). Conclusiones: La ausencia de diferencias entre ambos grupos sugiere que los regímenes de tratamiento antirretroviral de gran actividad que incluyen nevirapina durante la gestación no asocian un riesgo aumentado de hepatopatía en el lactante con respecto a otros regímenes (AU)


Background: The use of nevirapine in HIV-infected pregnant women is discouraged due to its potential to cause hepatotoxicity. There is limited information available on the toxicity in non-HIV infected newborn exposed to this drug during pregnancy. The aim of the study is to determine the extent of hepatotoxicity in the newborn exposed to nevirapine and HIV during pregnancy. Methods: A cross-sectional, observational, multicenter study was conducted on a cohort of healthy infants born to HIV-infected mothers, in whom the first determination of alanine aminotransferase (ALT), before 6 weeks of age, was collected. Patients were allocated to 2 groups according to exposure to nevirapine during pregnancy. Hepatotoxicity was rated according to the AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events (DAIDS). Results: This study included 160 newborns from 159 pregnancies (88 exposed to nevirapine-based regimens and 71 exposed to protease inhibitors-based therapies). No cases of hepatotoxicity were observed according to the DAIDS Table for Grading. Two cases of ALT above normal values (2.8%; 95% CI: 0.3-9.8%) were observed in patients not exposed to nevirapine, and one case (1.1%; 95% CI: 0.0-6.1%) in the group exposed to nevirapine (P = .585). Conclusion: The lack of differences between groups suggests that highly active antiretroviral treatment regimens including nevirapine administered during pregnancy do not involve a higher risk of liver disease compared to other treatment combinations (AU)


Assuntos
Humanos , Recém-Nascido , Doença Hepática Induzida por Substâncias e Drogas/epidemiologia , Antirretrovirais/efeitos adversos , Infecções por HIV/tratamento farmacológico , Exposição Materna/efeitos adversos , Fármacos Anti-HIV/farmacocinética , Complicações Infecciosas na Gravidez/tratamento farmacológico , Fatores de Risco
4.
Enferm Infecc Microbiol Clin ; 34(1): 39-44, 2016 Jan.
Artigo em Espanhol | MEDLINE | ID: mdl-25487604

RESUMO

BACKGROUND: The use of nevirapine in HIV-infected pregnant women is discouraged due to its potential to cause hepatotoxicity. There is limited information available on the toxicity in non-HIV infected newborn exposed to this drug during pregnancy. The aim of the study is to determine the extent of hepatotoxicity in the newborn exposed to nevirapine and HIV during pregnancy. METHODS: A cross-sectional, observational, multicenter study was conducted on a cohort of healthy infants born to HIV-infected mothers, in whom the first determination of alanine aminotransferase (ALT), before 6weeks of age, was collected. Patients were allocated to 2groups according to exposure to nevirapine during pregnancy. Hepatotoxicity was rated according to the AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events (DAIDS). RESULTS: This study included 160newborns from 159pregnancies (88exposed to nevirapine-based regimens and 71 exposed to protease inhibitors-based therapies). No cases of hepatotoxicity were observed according to the DAIDS Table for Grading. Two cases of ALT above normal values (2.8%; 95%CI: 0.3-9.8%) were observed in patients not exposed to nevirapine, and one case (1.1%; 95%CI: 0.0-6.1%) in the group exposed to nevirapine (P=.585). CONCLUSION: The lack of differences between groups suggests that highly active antiretroviral treatment regimens including nevirapine administered during pregnancy do not involve a higher risk of liver disease compared to other treatment combinations.


Assuntos
Doença Hepática Induzida por Substâncias e Drogas/epidemiologia , Exposição Materna/efeitos adversos , Nevirapina/efeitos adversos , Fármacos Anti-HIV/efeitos adversos , Estudos Transversais , Feminino , Infecções por HIV/tratamento farmacológico , Humanos , Lactente , Recém-Nascido , Gravidez , Complicações Infecciosas na Gravidez/virologia
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