Jaworsky Denise, Thompson Courtney, Yudin Mark H, Bitnun Ari, Brophy Jason, Samson Lindy, Antoniou Tony, Loutfy Mona R
Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Antivir Ther. 2010;15(4):677-80. doi: 10.3851/IMP1558.
Although antiretroviral therapy during pregnancy is associated with significant reductions in the risk of vertical transmission of HIV, attainment of this outcome in highly treatment-experienced pregnant women might be complicated by the lack of active drugs available to assemble a potent regimen. The recent licensing and availability of darunavir, etravirine and raltegravir has broadened management options available for highly treatment-experienced patients. However, data on their safety and efficacy in preventing vertical transmission are limited.
A retrospective chart review of two cases describing obstetrical, infant and treatment outcomes associated with the use of regimens that include darunavir and etravirine with or without raltegravir during pregnancy was conducted.
We document two cases of pregnant HIV-positive women treated with antiretroviral therapy including darunavir, etravirine and raltegravir. Vertical transmission was averted and no congenital anomalies were observed.
In the absence of human development toxicity data for these agents, these cases provide preliminary anecdotal data on their safety during pregnancy. Although the outcomes of these cases are reassuring, additional studies and registries are required to establish the safety and efficacy of these agents during pregnancy.
尽管孕期抗逆转录病毒疗法可显著降低HIV垂直传播的风险，但对于治疗经验丰富的孕妇而言，由于缺乏可用的活性药物来组建有效的治疗方案，实现这一目标可能会变得复杂。达芦那韦、依曲韦林和拉替拉韦最近获得许可并可使用，这拓宽了治疗经验丰富患者的管理选择。然而，关于它们在预防垂直传播方面的安全性和有效性的数据有限。
对两例病例进行回顾性图表审查，描述了孕期使用含或不含拉替拉韦的达芦那韦和依曲韦林治疗方案相关的产科、婴儿和治疗结局。
我们记录了两例接受包括达芦那韦、依曲韦林和拉替拉韦在内的抗逆转录病毒疗法治疗的HIV阳性孕妇病例。避免了垂直传播，且未观察到先天性异常。
在缺乏这些药物的人类发育毒性数据的情况下，这些病例提供了关于它们在孕期安全性的初步轶事性数据。尽管这些病例的结果令人安心，但仍需要更多的研究和登记来确定这些药物在孕期的安全性和有效性。
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