García-Fernández Lisset, Fiestas Fabián, Vásquez Rubén, Benites Carlos
Estrategia Sanitaria Nacional de ITS VIH/SIDA, Ministerio de Salud, Perú.
Instituto de Evaluación de Tecnologías en Salud e Investigación, Seguro Social de Salud-EsSalud, Lima, Perú.
Rev Chilena Infectol. 2016 Oct;33(Suppl 1):60-66. doi: 10.4067/S0716-10182016000700007.
The risk of mother to child transmission (MTCT) of HIV increases in pregnant women diagnosed late in pregnancy. Some experts suggest that the use of raltegravir (RAL), as part of the antiretroviral treatment in these pregnant women, could reduce the risk of MTCT, since RAL can quickly decrease the viral load.
To evaluate the available scientific information on the efficacy and safety of RAL, during the third trimester of pregnancy, in reducing MTCT of HIV.
We conducted a systematic review of the literature. The following databases were consulted: MEDLINE, Tripdatabase, Cochrane, Lilacs and Web of Science. We included systematic reviews, clinical trials, observational studies or case reports. The search was not filtered by language.
Fourteen studies met the inclusion criteria. Selected studies were case reports or case series. We included, in total, 44 pregnancies (with 45 live births). A case of TMI of HIV was reported. Eight studies reported adverse events, of which four cases can be attributed to the use of RAL.
There is insufficient evidence on the efficacy and safety of RAL to decrease the risk of MTCT in HIV pregnant women who present in the last trimester of pregnancy.
妊娠晚期确诊的孕妇中，人类免疫缺陷病毒（HIV）母婴传播（MTCT）的风险会增加。一些专家认为，在这些孕妇的抗逆转录病毒治疗中使用拉替拉韦（RAL），可能会降低MTCT的风险，因为RAL可以迅速降低病毒载量。
评估妊娠晚期使用RAL降低HIV母婴传播风险的有效性和安全性的现有科学信息。
我们对文献进行了系统综述。查阅了以下数据库：MEDLINE、Tripdatabase、Cochrane、Lilacs和科学网。我们纳入了系统综述、临床试验、观察性研究或病例报告。检索未按语言进行筛选。
14项研究符合纳入标准。所选研究为病例报告或病例系列。我们总共纳入了44例妊娠（45例活产）。报告了1例HIV垂直传播感染病例。8项研究报告了不良事件，其中4例可归因于RAL的使用。
对于妊娠晚期出现的HIV感染孕妇，关于RAL降低MTCT风险的有效性和安全性，证据不足。
