Transplacental passage of protease inhibitors at delivery.

Details

Serval ID
serval:BIB_24752
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Transplacental passage of protease inhibitors at delivery.
Journal
AIDS
Author(s)
Marzolini C., Rudin C., Decosterd L.A., Telenti A., Schreyer A., Biollaz J., Buclin T.
ISSN
0269-9370
Publication state
Published
Issued date
2002
Peer-reviewed
Oui
Volume
16
Number
6
Pages
889-893
Language
english
Abstract
OBJECTIVE: Although combinations of different antiretroviral drugs are increasingly used by pregnant HIV-1-infected women, few human data are available to evaluate in utero protease inhibitors (PI) exposure. The aim of this study was to assess the extent of transplacental passage of PI at delivery. METHODS: Pregnant women treated with antiretroviral drugs including PI and/or nevirapine were eligible for the study. Placental transfer was determined by comparison of drug concentrations in blood samples simultaneously collected from a peripheral maternal vein and the umbilical cord at delivery. Drug levels were determined by high-performance liquid chromatography. RESULTS: Thirteen maternal-cord blood sample pairs were evaluable for transplacental passage determination (nine nelfinavir, two ritonavir, one saquinavir, one lopinavir, two nevirapine). Median cord and maternal drug concentrations, respectively, were nelfinavir < 250 and 1110 ng/ml; ritonavir < 250 and 1113 ng/ml; saquinavir < 100 and 350 ng/ml; lopinavir < 250 and 3105 ng/ml and nevirapine 2072 and 2546 ng/ml. The cord-to-maternal blood ratio was extremely low for all PI. CONCLUSION: PI do not cross the placenta to an appreciable extent and consequently cannot be expected to exert a direct antiviral activity in utero during the whole dosing interval. Limited transfer may result from their high degree of plasma protein binding and their backwards transport through P-glycoprotein, largely expressed in the placenta. In contrast, nevirapine readily crosses the placental barrier. Such considerations may support treatment decisions in pregnant women.
Keywords
Chromatography, High Pressure Liquid, Cohort Studies, Delivery, Obstetric, Female, Fetal Blood, HIV Infections, HIV Protease Inhibitors, Humans, Maternal-Fetal Exchange, Pregnancy, Viral Load
Pubmed
Web of science
Create date
19/11/2007 13:20
Last modification date
20/08/2019 14:02
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