AbbVie Inc., 1 Waukegan Road, North Chicago, IL 60064, USA.
AIDS Rev. 2013 Jan-Mar;15(1):38-48.
The co-formulated, ritonavir-boosted protease inhibitor lopinavir is a frequently used component of HAART for treatment of HIV-infected women during pregnancy and prevention of mother-to-child transmission. We performed a systematic review to assess the effects of lopinavir/ritonavir on maternal and infant clinical and safety outcomes in HIV-infected pregnant women. PubMed, EMBASE, and select congresses were searched for studies published through May 31, 2012. Studies were selected that included HIV-infected pregnant mothers treated with a lopinavir/ritonavir-based regimen and described relevant maternal and infant outcomes. Ten articles or presentations describing nine studies were identified, comprising 2,675 lopinavir/ritonavir-treated women. In studies reporting HIV-1 RNA at delivery, HIV-1 RNA < 200 to < 1,000 copies/ml was achieved in 64-97% of subjects. Preterm delivery (< 37 weeks gestation) rates ranged from 8.3 to 25%; low birth weight (< 2,500 g) rates ranged from 11 to 20.3%. In one study, preterm delivery rates and low birth weight were similar between women who received standard or increased doses of lopinavir/ritonavir. In five studies reporting stillbirths and live births, 38 stillbirths occurred versus 2,058 live births (1.8%) among women receiving lopinavir/ritonavir. In eight studies reporting mother-to-child transmission at different time points, rates ranged from 0 to 3.3% and appeared to be similar in the one study comparing pregnant women who received standard or higher doses of lopinavir/ritonavir. The results from this systematic review suggest no unique safety or efficacy concerns with use of standard dose lopinavir/ritonavir as part of HAART in pregnant women.
洛匹那韦利托那韦是一种复方、利托那韦增强的蛋白酶抑制剂，常用于治疗妊娠期感染 HIV 的妇女的高效抗逆转录病毒治疗（HAART），以预防母婴传播。我们进行了一项系统评价，以评估洛匹那韦/利托那韦对感染 HIV 的孕妇的母婴临床和安全性结局的影响。我们检索了截至 2012 年 5 月 31 日发表的文献，包括 PubMed、EMBASE 和部分会议。纳入了使用洛匹那韦/利托那韦方案治疗的 HIV 感染孕妇，并描述了相关母婴结局的研究。确定了 10 篇文章或报告，其中 9 项研究，共包括 2675 名接受洛匹那韦/利托那韦治疗的妇女。在报告分娩时 HIV-1 RNA 的研究中，64%-97%的患者 HIV-1 RNA<200 至<1000 拷贝/ml。早产（<37 周妊娠）率为 8.3%-25%；低出生体重（<2500 g）率为 11%-20.3%。在一项研究中，接受标准或增加剂量洛匹那韦/利托那韦的妇女的早产率和低出生体重相似。在报告死产和活产的 5 项研究中，接受洛匹那韦/利托那韦的妇女中有 38 例死产，2058 例活产（1.8%）。在报告不同时间点母婴传播率的 8 项研究中，传播率为 0-3.3%，在一项比较接受标准或更高剂量洛匹那韦/利托那韦的孕妇的研究中，母婴传播率似乎相似。本系统评价的结果表明，标准剂量洛匹那韦/利托那韦作为 HAART 的一部分用于妊娠期妇女时，没有独特的安全性或疗效问题。
