Children's and Women's Health Centre of British Columbia, Vancouver, British Columbia, Canada.
Oak Tree Clinic, BC Women's Hospital, Vancouver, British Columbia, Canada.
HIV Med. 2024 Jan;25(1):129-134. doi: 10.1111/hiv.13546. Epub 2023 Oct 10.
Ritonavir-boosted darunavir (DRV/r) is a preferred protease inhibitor in pregnant women living with HIV. Current practice at British Columbia's referral centre (the Oak Tree Clinic) is to dose DRV/r as 800/100 mg daily throughout pregnancy, although some guidelines recommend DRV/r 600/100 mg twice daily due to altered pharmacokinetics with once-daily dosing.
We describe the effect of once-daily DRV/r on viral suppression, vertical transmission, adverse drug effects and adherence in pregnant women living with HIV.
This was a retrospective analysis of pregnant women living with HIV in British Columbia. Eligible women gave birth between January 2015 and August 2021, and took DRV/r 800/100 mg daily at any time during pregnancy.
Thirty-four women were included in this study. The mean (SD) age was 33 (5) years. Thirty (88%) women were diagnosed with HIV prior to pregnancy, with 22 (73%) having viral suppression at baseline. Four (12%) were diagnosed in pregnancy, with a median baseline viral load of 9616 copies/mL (range 8370-165 000). Viral suppression was achieved by 16 (100%), 24 (75%) and 26 (74%) women in the first, second and third trimesters, respectively. No vertical transmission occurred. This combination was well tolerated, with adverse drug effects that did not result in discontinuation or change in therapy. Most women maintained >75% adherence to once-daily DRV/r at all times during pregnancy.
Ritonavir-boosted darunavir 800/100 mg daily appears to be an appropriate dosing strategy for pregnant women living with HIV who are able to maintain optimal adherence.
利托那韦增强后的达芦那韦（DRV/r）是 HIV 感染者孕妇的首选蛋白酶抑制剂。在不列颠哥伦比亚省转诊中心（橡树诊所），目前的做法是在整个孕期每天给予 DRV/r800/100mg，尽管一些指南建议由于每日一次给药时药代动力学改变，DRV/r 600/100mg 每日两次。
我们描述了每日一次 DRV/r 对 HIV 感染者孕妇的病毒抑制、垂直传播、药物不良反应和依从性的影响。
这是对不列颠哥伦比亚省 HIV 感染者孕妇的回顾性分析。符合条件的孕妇于 2015 年 1 月至 2021 年 8 月分娩，且在孕期的任何时候都服用 DRV/r800/100mg 每日一次。
本研究纳入了 34 名孕妇。平均（SD）年龄为 33（5）岁。30（88%）名妇女在怀孕前被诊断出 HIV，其中 22（73%）人在基线时病毒得到抑制。4（12%）名妇女在妊娠期间被诊断出 HIV，基线病毒载量中位数为 9616 拷贝/ml（范围 8370-165000）。分别有 16（100%）、24（75%）和 26（74%）名妇女在第一、第二和第三孕期实现了病毒抑制。无垂直传播。该联合用药耐受良好，药物不良反应未导致停药或治疗改变。大多数妇女在孕期任何时候都保持了 >75%的每日一次 DRV/r 依从性。
对于能够维持最佳依从性的 HIV 感染者孕妇，每日给予利托那韦增强后的达芦那韦 800/100mg 似乎是一种合适的给药方案。
