Safety of protease inhibitors in HIV-infected pregnant women

Imène Chougrani,1 Dominique Luton,1,2 Sophie Matheron,3 Laurent Mandelbrot,2,4 Elie Azria1,2 1Department of Obstetrics and Gynecology, Bichat Claude Bernard Hospital, Paris Diderot University, Paris, 2Departement Hospitalo-Universitaire "Risk and Pregnancy", Paris, 3Department o...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Chougrani I, Luton D, Matheron S, Mandelbrot L, Azria E
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2013
Materias:	Immunologic diseases. Allergy RC581-607
Acceso en línea:	https://doaj.org/article/b76ee7f355e64f099a6ee8cd85456143
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:b76ee7f355e64f099a6ee8cd85456143
record_format	dspace
spelling	oai:doaj.org-article:b76ee7f355e64f099a6ee8cd854561432021-12-02T01:02:48ZSafety of protease inhibitors in HIV-infected pregnant women1179-1373https://doaj.org/article/b76ee7f355e64f099a6ee8cd854561432013-09-01T00:00:00Zhttp://www.dovepress.com/safety-of-protease-inhibitors-in-hiv-infected-pregnant-women-a14504https://doaj.org/toc/1179-1373Imène Chougrani,1 Dominique Luton,1,2 Sophie Matheron,3 Laurent Mandelbrot,2,4 Elie Azria1,2 1Department of Obstetrics and Gynecology, Bichat Claude Bernard Hospital, Paris Diderot University, Paris, 2Departement Hospitalo-Universitaire "Risk and Pregnancy", Paris, 3Department of Infectious and Tropical Diseases, Bichat Claude Bernard Hospital, Paris Diderot University, Paris, 4Department of Obstetrics and Gynecology, Louis Mourier Hospital, Paris Diderot University, Colombes, France Abstract: The dire conditions of the human immunodeficiency virus/acquired immune deficiency syndrome epidemic and the immense benefits of antiretroviral prophylaxis in prevention of mother-to-child transmission far outweigh the potential for adverse effects and undeniably justify the rapid and widespread use of this therapy, despite incomplete safety data. Highly active antiretroviral therapy has now become standard care, and more than half the validated regimens include protease inhibitors. This paper reviews current knowledge of the safety of these drugs during pregnancy, in terms of maternal and fetal outcomes. Transfer of protease inhibitors across the placenta is known to be minimal, and current data about birth defects and fetal malignancies are reassuring. Maternal liver function and glucose metabolism should be monitored in women treated with protease inhibitor-based regimens, but concerns about the development of maternal resistance, should treatment be discontinued, have been shown to be groundless. Neonates should be screened for hematologic abnormalities, although these are rarely severe or permanent and are not usually related to the protease inhibitor component of the antiretroviral combination. Current findings concerning pre-eclampsia and growth restriction are discordant, and further research is needed to address the question of placental vascular complications. The increased risk of preterm birth attributed to protease inhibitors should be interpreted with caution considering the discrepant results and the multitude of confounding factors often overlooked. Although data are thus far reassuring, further research is needed to shed light on unresolved controversies about the safety of protease inhibitors during pregnancy. Keywords: human immunodeficiency virus, pregnancy, protease inhibitorsChougrani ILuton DMatheron SMandelbrot LAzria EDove Medical PressarticleImmunologic diseases. AllergyRC581-607ENHIV/AIDS: Research and Palliative Care, Vol 2013, Iss default, Pp 253-262 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Immunologic diseases. Allergy RC581-607
spellingShingle	Immunologic diseases. Allergy RC581-607 Chougrani I Luton D Matheron S Mandelbrot L Azria E Safety of protease inhibitors in HIV-infected pregnant women
description	Imène Chougrani,1 Dominique Luton,1,2 Sophie Matheron,3 Laurent Mandelbrot,2,4 Elie Azria1,2 1Department of Obstetrics and Gynecology, Bichat Claude Bernard Hospital, Paris Diderot University, Paris, 2Departement Hospitalo-Universitaire "Risk and Pregnancy", Paris, 3Department of Infectious and Tropical Diseases, Bichat Claude Bernard Hospital, Paris Diderot University, Paris, 4Department of Obstetrics and Gynecology, Louis Mourier Hospital, Paris Diderot University, Colombes, France Abstract: The dire conditions of the human immunodeficiency virus/acquired immune deficiency syndrome epidemic and the immense benefits of antiretroviral prophylaxis in prevention of mother-to-child transmission far outweigh the potential for adverse effects and undeniably justify the rapid and widespread use of this therapy, despite incomplete safety data. Highly active antiretroviral therapy has now become standard care, and more than half the validated regimens include protease inhibitors. This paper reviews current knowledge of the safety of these drugs during pregnancy, in terms of maternal and fetal outcomes. Transfer of protease inhibitors across the placenta is known to be minimal, and current data about birth defects and fetal malignancies are reassuring. Maternal liver function and glucose metabolism should be monitored in women treated with protease inhibitor-based regimens, but concerns about the development of maternal resistance, should treatment be discontinued, have been shown to be groundless. Neonates should be screened for hematologic abnormalities, although these are rarely severe or permanent and are not usually related to the protease inhibitor component of the antiretroviral combination. Current findings concerning pre-eclampsia and growth restriction are discordant, and further research is needed to address the question of placental vascular complications. The increased risk of preterm birth attributed to protease inhibitors should be interpreted with caution considering the discrepant results and the multitude of confounding factors often overlooked. Although data are thus far reassuring, further research is needed to shed light on unresolved controversies about the safety of protease inhibitors during pregnancy. Keywords: human immunodeficiency virus, pregnancy, protease inhibitors
format	article
author	Chougrani I Luton D Matheron S Mandelbrot L Azria E
author_facet	Chougrani I Luton D Matheron S Mandelbrot L Azria E
author_sort	Chougrani I
title	Safety of protease inhibitors in HIV-infected pregnant women
title_short	Safety of protease inhibitors in HIV-infected pregnant women
title_full	Safety of protease inhibitors in HIV-infected pregnant women
title_fullStr	Safety of protease inhibitors in HIV-infected pregnant women
title_full_unstemmed	Safety of protease inhibitors in HIV-infected pregnant women
title_sort	safety of protease inhibitors in hiv-infected pregnant women
publisher	Dove Medical Press
publishDate	2013
url	https://doaj.org/article/b76ee7f355e64f099a6ee8cd85456143
work_keys_str_mv	AT chougranii safetyofproteaseinhibitorsinhivinfectedpregnantwomen AT lutond safetyofproteaseinhibitorsinhivinfectedpregnantwomen AT matherons safetyofproteaseinhibitorsinhivinfectedpregnantwomen AT mandelbrotl safetyofproteaseinhibitorsinhivinfectedpregnantwomen AT azriae safetyofproteaseinhibitorsinhivinfectedpregnantwomen
_version_	1718403340379881472

Safety of protease inhibitors in HIV-infected pregnant women

Ejemplares similares