title: Use of newer antiretroviral agents, darunavir and etravirine with or without raltegravir, in pregnancy: a report of two cases.
abstract: BACKGROUND
  Although antiretroviral therapy during pregnancy is associated with significant reductions in the risk of vertical transmission of HIV, attainment of this outcome in highly treatment-experienced pregnant women might be complicated by the lack of active drugs available to assemble a potent regimen. The recent licensing and availability of darunavir, etravirine and raltegravir has broadened management options available for highly treatment-experienced patients. However, data on their safety and efficacy in preventing vertical transmission are limited.
  
  
  METHODS
  A retrospective chart review of two cases describing obstetrical, infant and treatment outcomes associated with the use of regimens that include darunavir and etravirine with or without raltegravir during pregnancy was conducted.
  
  
  RESULTS
  We document two cases of pregnant HIV-positive women treated with antiretroviral therapy including darunavir, etravirine and raltegravir. Vertical transmission was averted and no congenital anomalies were observed.
  
  
  CONCLUSIONS
  In the absence of human development toxicity data for these agents, these cases provide preliminary anecdotal data on their safety during pregnancy. Although the outcomes of these cases are reassuring, additional studies and registries are required to establish the safety and efficacy of these agents during pregnancy.
authors.affiliation: Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
authors.forename: Denise
authors.initials: D
authors.lastname: Jaworsky
authors.forename: Courtney
authors.initials: C
authors.lastname: Thompson
authors.forename: Mark H
authors.initials: MH
authors.lastname: Yudin
authors.forename: Ari
authors.initials: A
authors.lastname: Bitnun
authors.forename: Jason
authors.initials: J
authors.lastname: Brophy
authors.forename: Lindy
authors.initials: L
authors.lastname: Samson
authors.forename: Tony
authors.initials: T
authors.lastname: Antoniou
authors.forename: Mona R
authors.initials: MR
authors.lastname: Loutfy
mesh_terms: D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000069454:Darunavir; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D009570:Nitriles; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy* / Q000821:virology; D011724:Pyridazines / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D011743:Pyrimidines; D011760:Pyrrolidinones / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000068898:Raltegravir Potassium; D018894:Reverse Transcriptase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D013449:Sulfonamides / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents; D009570:Nitriles; D011724:Pyridazines; D011743:Pyrimidines; D011760:Pyrrolidinones; D018894:Reverse Transcriptase Inhibitors; D013449:Sulfonamides; C451734:etravirine; D000068898:Raltegravir Potassium; D000069454:Darunavir