title: Safety and tolerability of antiretrovirals during pregnancy.
abstract: Combination antiretroviral therapy (CART) dramatically decreases mother-to-child HIV-1 transmission (MTCT), but maternal adverse events are not infrequent. A review of 117 locally followed pregnancies revealed 7 grade ≥ 3 AEs possibly related to antiretrovirals, including 2 hematologic, 3 hepatic, and 2 obstetric cholestasis cases. A fetal demise was attributed to obstetric cholestasis, but no maternal deaths occurred. The drugs possibly associated with these AE were zidovudine, nelfinavir, lopinavir/ritonavir, and indinavir. AE or intolerability required discontinuation/substitution of nevirapine in 16% of the users, zidovudine in 10%, nelfinavir in 9%, lopinavir/ritonavir in 1%, but epivir and stavudine in none. In conclusion, nevirapine, zidovudine, and nelfinavir had the highest frequency of AE and/or the lowest tolerability during pregnancy. Although nevirapine and nelfinavir are infrequently used in pregnancy at present, zidovudine is included in most MTCT preventative regimens. Our data emphasize the need to revise the treatment recommendations for pregnant women to include safer and better-tolerated drugs.
authors: School of Medicine University of Colorado Denver, Research Complex, Aurora, CO 80045, USA. adriana.weinberg@ucdenver.edu
authors: Adriana
authors: A
authors: Weinberg
authors: Jeri
authors: J
authors: Forster-Harwood
authors: Jill
authors: J
authors: Davies
authors: Elizabeth J
authors: EJ
authors: McFarland
authors: Jennifer
authors: J
authors: Pappas
authors: Kay
authors: K
authors: Kinzie
authors: Emily
authors: E
authors: Barr
authors: Suzanne
authors: S
authors: Paul
authors: Carol
authors: C
authors: Salbenblatt
authors: Elizabeth
authors: E
authors: Soda
authors: Anna
authors: A
authors: Vazquez
authors: Myron J
authors: MJ
authors: Levin
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