title: Nelfinavir plasma concentrations are low during pregnancy.
abstract: Plasma nelfinavir concentration ratios (CRs) were calculated for all pregnant (n=27) and nonpregnant (n=48) human immunodeficiency virus type 1-infected women receiving the drug who visited our outpatient clinic. In pregnant women, mean and median nelfinavir CRs were significantly lower (P=.02 and P=.04, respectively), and 51% of the CRs were below the clinically relevant threshold of 0.90, compared with 35% of the CRs in nonpregnant women. After we adjusted for confounders, we found that the mean nelfinavir CR was 34% lower in pregnant women (P=.02). With targeted interventions, subsequent CRs in pregnant women showed a significant increase (median increase, 0.31; P=.01).
authors.affiliation: Academic Medical Center, Department of Internal Medicine, Division of Infectious Diseases, Tropical Medicine, and AIDS, Amsterdam, The Netherlands.
authors.forename: Jeannine F J B
authors.initials: JF
authors.lastname: Nellen
authors.forename: Igor
authors.initials: I
authors.lastname: Schillevoort
authors.forename: Ferdinand W N M
authors.initials: FW
authors.lastname: Wit
authors.forename: Alina S
authors.initials: AS
authors.lastname: Bergshoeff
authors.forename: Mieke H
authors.initials: MH
authors.lastname: Godfried
authors.forename: Kees
authors.initials: K
authors.lastname: Boer
authors.forename: Joep M A
authors.initials: JM
authors.lastname: Lange
authors.forename: David M
authors.initials: DM
authors.lastname: Burger
authors.forename: Jan M
authors.initials: JM
authors.lastname: Prins
mesh_terms: D000328:Adult; D015986:Confounding Factors, Epidemiologic; D004334:Drug Administration Schedule; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy*; D017320:HIV Protease Inhibitors / Q000097:blood / Q000627:therapeutic use; D015497:HIV-1 / Q000187:drug effects*; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D019888:Nelfinavir / Q000008:administration & dosage / Q000097:blood* / Q000627:therapeutic use*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000097:blood* / Q000188:drug therapy* / Q000821:virology; D011261:Pregnancy Trimester, First / Q000097:blood / Q000187:drug effects; D011262:Pregnancy Trimester, Second / Q000097:blood / Q000187:drug effects; D011263:Pregnancy Trimester, Third / Q000097:blood / Q000187:drug effects
chemical_list: D017320:HIV Protease Inhibitors; D019888:Nelfinavir