title: Stavudine concentrations in women receiving postpartum antiretroviral treatment and their breastfeeding infants.
abstract: First-line antiretroviral treatment regimens in resource-limited settings used in breastfeeding mothers often include stavudine (d4T). Limited data describing d4T concentrations in breast milk are available. We analyzed d4T concentrations in 52 mother-infant pairs using ultra-performance liquid chromatography-tandem mass spectrometry (lower limit of quantification: 5 ng/mL in plasma, 20 ng/mL in breast milk). Median (interquartile range) d4T concentrations were 86 (36-191) ng/mL in maternal plasma, 151 (48-259) ng/mL in whole milk, 190 (58-296) ng/mL in skim milk, and <5 (<5 to <5) ng/mL in infant plasma. Although d4T is concentrated in breast milk relative to maternal plasma, the infant d4T dose received from breast milk is very small and not clinically significant.
authors.affiliation: Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA. jfogel@jhmi.edu
authors.forename: Jessica M
authors.initials: JM
authors.lastname: Fogel
authors.forename: Taha E
authors.initials: TE
authors.lastname: Taha
authors.forename: Jin
authors.initials: J
authors.lastname: Sun
authors.forename: Donald R
authors.initials: DR
authors.lastname: Hoover
authors.forename: Teresa L
authors.initials: TL
authors.lastname: Parsons
authors.forename: Johnstone J
authors.initials: JJ
authors.lastname: Kumwenda
authors.forename: Lynne M
authors.initials: LM
authors.lastname: Mofenson
authors.forename: Mary Glenn
authors.initials: MG
authors.lastname: Fowler
authors.forename: Craig W
authors.initials: CW
authors.lastname: Hendrix
authors.forename: Newton I
authors.initials: NI
authors.lastname: Kumwenda
authors.forename: Susan H
authors.initials: SH
authors.lastname: Eshleman
authors.forename: Mark
authors.initials: M
authors.lastname: Mirochnick
mesh_terms: D019380:Anti-HIV Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics*; D001942:Breast Feeding; D002853:Chromatography, Liquid; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008895:Milk, Human / Q000737:chemistry*; D049590:Postpartum Period; D018119:Stavudine / Q000008:administration & dosage* / Q000493:pharmacokinetics*; D053719:Tandem Mass Spectrometry
chemical_list: D019380:Anti-HIV Agents; D018119:Stavudine