Clarke Diana F, Penazzato Martina, Capparelli Edmund, Cressey Tim R, Siberry George, Sugandhi Nandita, Mirochnick Mark
a Department of Pediatric Infectious Diseases , Boston Medical Center , Boston , MA , USA.
b Department of Pediatrics , Boston University School of Medicine , Boston , MA , USA.
Expert Rev Clin Pharmacol. 2018 Jan;11(1):83-93. doi: 10.1080/17512433.2018.1393331. Epub 2017 Nov 8.
Antiretroviral drugs are used in neonates for prevention and treatment of HIV infection. Use of antiretrovirals to prevent perinatal HIV transmission is well established. Early identification of neonates infected with HIV and rapid initiation of combination antiretroviral treatment during the neonatal period is now recommended by WHO and DHHS. However, few antiretrovirals are available in formulations suitable for neonates and there are limited safety and pharmacokinetic data for most antiretrovirals in neonates. Areas covered: We summarize existing neonatal antiretroviral safety and pharmacokinetic information and discuss implementation considerations for programs providing antiretrovirals to neonates and young infants. Expert commentary: Antiretrovirals currently recommended by WHO for use in neonates are zidovudine, lamivudine, lopinavir/ritonavir, nevirapine, and raltegravir. Significant implementation challenges exist to the widespread use of these antiretrovirals in neonates. Optimal, feasible treatment of HIV-exposed and HIV-infected newborns will require development of practical neonatal dosage forms and their study in neonates for a wide range of antiretrovirals.
抗逆转录病毒药物用于新生儿预防和治疗HIV感染。使用抗逆转录病毒药物预防围产期HIV传播已得到充分证实。世界卫生组织（WHO）和美国卫生与公众服务部（DHHS）目前建议，尽早识别感染HIV的新生儿，并在新生儿期迅速开始联合抗逆转录病毒治疗。然而，适合新生儿使用的抗逆转录病毒药物制剂很少，大多数抗逆转录病毒药物在新生儿中的安全性和药代动力学数据有限。涵盖领域：我们总结了现有的新生儿抗逆转录病毒药物安全性和药代动力学信息，并讨论了为新生儿和幼儿提供抗逆转录病毒药物的项目的实施注意事项。专家评论：WHO目前推荐用于新生儿的抗逆转录病毒药物有齐多夫定、拉米夫定、洛匹那韦/利托那韦、奈韦拉平和拉替拉韦。在新生儿中广泛使用这些抗逆转录病毒药物存在重大的实施挑战。对暴露于HIV和感染HIV的新生儿进行最佳、可行的治疗将需要开发实用的新生儿剂型，并在新生儿中对多种抗逆转录病毒药物进行研究。
