Lyons F, Hopkins S, Kelleher B, McGeary A, Sheehan G, Geoghegan J, Bergin C, Mulcahy F M, McCormick P A
Department of Genitourinary Medicine and Infectious Diseases, St James's Hospital, Dublin, Ireland.
HIV Med. 2006 May;7(4):255-60. doi: 10.1111/j.1468-1293.2006.00369.x.
To describe the maternal tolerability of nevirapine as part of combination antiretroviral therapy in pregnancy at three HIV centres in Dublin, Ireland and to determine risk factors for development of significant hepatotoxicity.
A retrospective study was carried out of all women prescribed nevirapine as part of combination antiretroviral therapy in pregnancy at three HIV centres in Dublin, Ireland (October 2000 to February 2003). Toxicities experienced were graded according to the Division of AIDS toxicity guidelines for adults. Statistical analysis was performed to determine whether there were differences between those that did and those that did not experience significant hepatotoxicity.
A total of 123 women initiated nevirapine as part of combination antiretroviral therapy in the study period. Eight women developed significant hepatotoxicity, including two women who died from fulminant hepatitis. Women who experienced more severe hepatotoxicity had higher pretreatment CD4 counts (P=0.01).
In this cohort, women who experienced more severe hepatotoxicity had higher pretreatment CD4 counts, lending additional weight to the need for caution in using nevirapine as part of combination antiretroviral therapy in women not requiring antiretroviral therapy for their own health.
描述在爱尔兰都柏林的三个艾滋病防治中心，奈韦拉平作为孕期抗逆转录病毒联合疗法一部分时的母体耐受性，并确定发生严重肝毒性的危险因素。
对2000年10月至2003年2月期间在爱尔兰都柏林的三个艾滋病防治中心接受奈韦拉平治疗、作为孕期抗逆转录病毒联合疗法一部分的所有女性进行回顾性研究。根据美国国立卫生院艾滋病司成人毒性指南对所经历的毒性进行分级。进行统计分析以确定发生严重肝毒性和未发生严重肝毒性的患者之间是否存在差异。
在研究期间，共有123名女性开始使用奈韦拉平作为抗逆转录病毒联合疗法的一部分。8名女性出现严重肝毒性，其中两名女性死于暴发性肝炎。发生更严重肝毒性的女性治疗前CD4细胞计数较高（P = 0.01）。
在该队列中，发生更严重肝毒性的女性治疗前CD4细胞计数较高，这进一步说明对于自身健康不需要抗逆转录病毒治疗的女性，在使用奈韦拉平作为抗逆转录病毒联合疗法一部分时需要谨慎。
