Antiretroviral Therapy in Pregnancy: A 2023 Review of the Literature.

IF 3.7 2区医学 Q2 INFECTIOUS DISEASES Current HIV/AIDS Reports Pub Date : 2024-02-01 Epub Date: 2024-01-26 DOI:10.1007/s11904-024-00688-y

Alison N Goulding, Kasey Meeks, Lena Shay, Sarah Casey, Colton Applegarth, Jennifer McKinney

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Abstract

Purpose of review: Selection of antiretroviral therapy during pregnancy must consider maternal physiology and resulting pharmacokinetic changes in pregnancy, resistance and efficacy profiles, tolerability and frequency of adverse effects, teratogenicity, and maternal, neonatal, and pregnancy outcomes. The objective of this review is to summarize the underlying data that informs the current clinical perinatal guidelines in the USA.

Recent findings: Data now supports the use of dolutegravir at all stages of pregnancy with no significant increase in neural tube defects. Safety and pharmacokinetic data on newer antiretroviral medications in pregnancy continue to lag behind the general population. While there are multiple safety and tolerability concerns with older regimens, there are now multiple options of regimens that are highly efficacious and have good safety data in pregnancy. Most pregnant patients who are virally suppressed on a well-tolerated regimen are able to safely continue those medications during pregnancy.

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妊娠期抗逆转录病毒疗法：2023 年文献综述》。

审查目的：妊娠期抗逆转录病毒疗法的选择必须考虑妊娠期母体的生理学和由此产生的药代动力学变化、耐药性和疗效概况、耐受性和不良反应频率、致畸性以及母体、新生儿和妊娠结局。本综述旨在总结美国现行围产期临床指南的基础数据：目前的数据支持在妊娠的各个阶段使用多鲁曲韦，神经管畸形的发生率没有明显增加。新型抗逆转录病毒药物在妊娠期的安全性和药代动力学数据仍然落后于普通人群。虽然旧的治疗方案存在多种安全性和耐受性问题，但现在有多种治疗方案可供选择，这些方案在妊娠期具有很高的疗效和良好的安全性数据。大多数采用耐受性良好的治疗方案且病毒已被抑制的妊娠期患者都可以在妊娠期间安全地继续服用这些药物。

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来源期刊

Current HIV/AIDS Reports INFECTIOUS DISEASES-

CiteScore

8.10

自引率

2.20%

发文量

期刊介绍： This journal intends to provide clear, insightful, balanced contributions by international experts that review the most important, recently published clinical findings related to the diagnosis, treatment, management, and prevention of HIV/AIDS. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as antiretroviral therapies, behavioral aspects of management, and metabolic complications and comorbidity. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.