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抗病毒药物和疫苗在孕妇中的安全性与有效性:基于生理的药代动力学建模及病毒感染动力学整合的见解

Safety and Efficacy of Antiviral Drugs and Vaccines in Pregnant Women: Insights from Physiologically Based Pharmacokinetic Modeling and Integration of Viral Infection Dynamics.

作者信息

Costa Bárbara, Gouveia Maria João, Vale Nuno

机构信息

PerMed Research Group, Center for Health Technology and Services Research (CINTESIS), 4200-450 Porto, Portugal.

CINTESIS@RISE, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal.

出版信息

Vaccines (Basel). 2024 Jul 16;12(7):782. doi: 10.3390/vaccines12070782.

Abstract

Addressing the complexities of managing viral infections during pregnancy is essential for informed medical decision-making. This comprehensive review delves into the management of key viral infections impacting pregnant women, namely Human Immunodeficiency Virus (HIV), Hepatitis B Virus/Hepatitis C Virus (HBV/HCV), Influenza, Cytomegalovirus (CMV), and SARS-CoV-2 (COVID-19). We evaluate the safety and efficacy profiles of antiviral treatments for each infection, while also exploring innovative avenues such as gene vaccines and their potential in mitigating viral threats during pregnancy. Additionally, the review examines strategies to overcome challenges, encompassing prophylactic and therapeutic vaccine research, regulatory considerations, and safety protocols. Utilizing advanced methodologies, including PBPK modeling, machine learning, artificial intelligence, and causal inference, we can amplify our comprehension and decision-making capabilities in this intricate domain. This narrative review aims to shed light on diverse approaches and ongoing advancements, this review aims to foster progress in antiviral therapy for pregnant women, improving maternal and fetal health outcomes.

摘要

应对孕期病毒感染管理的复杂性对于做出明智的医疗决策至关重要。本全面综述深入探讨了影响孕妇的主要病毒感染的管理,即人类免疫缺陷病毒(HIV)、乙型肝炎病毒/丙型肝炎病毒(HBV/HCV)、流感、巨细胞病毒(CMV)和严重急性呼吸综合征冠状病毒2(SARS-CoV-2,即新冠病毒)。我们评估了针对每种感染的抗病毒治疗的安全性和有效性,同时还探索了创新途径,如基因疫苗及其在减轻孕期病毒威胁方面的潜力。此外,该综述还研究了克服挑战的策略,包括预防性和治疗性疫苗研究、监管考量以及安全协议。利用先进的方法,包括生理药代动力学(PBPK)建模、机器学习、人工智能和因果推断,我们可以增强在这个复杂领域的理解和决策能力。本叙述性综述旨在阐明各种方法和正在取得的进展,以促进孕妇抗病毒治疗的进步,改善母婴健康结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18a9/11281481/42d220b8c9f6/vaccines-12-00782-g001.jpg

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