Increase in transaminase levels following the use of raltegravir in a woman with a high HIV viral load at 35 weeks of pregnancy.
BACKGROUND
Despite the efficacy of raltegravir in reducing viral load in HIV-infected patients, evidence for its safety in late pregnancy is lacking. A high rate of placental transfer was recently demonstrated.


METHODS
A treatment-naïve 34-year-old HIV-1-positive woman of African origin began treatment with zidovudine/lamivudine, lopinavir/ritonavir, and raltegravir at 35 weeks of pregnancy. After 11 days of treatment with raltegravir, a substantial reduction in viral load was achieved. Concurrently, she had a 23-fold increase in serum alanine aminotransferase and a 10-fold increase in serum aspartate aminotransferase, both of which returned to normal when raltegravir treatment was discontinued. A healthy boy was delivered at term. The infant's tests for HIV were negative at five months, and he had no health problems at eight months.


CONCLUSIONS
This is the first case report, to our knowledge, of increased maternal serum transaminase levels following the use of raltegravir in a woman at a late stage of pregnancy.
Pharmacy Practice Research Unit (PPRU), CHU Sainte-Justine, Montreal QC, Pharmacy Department, Paris-Descartes University, Paris, France.
Sophie
S
Renet
Aurélie
A
Closon
Marie-Sophie
MS
Brochet
Jean-François
JF
Bussières
Marc
M
Boucher
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood*; D001219:Aspartate Aminotransferases / Q000097:blood*; D005260:Female; D005865:Gestational Age; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000821:virology; D015497:HIV-1; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000821:virology*; D011256:Pregnancy Outcome; D011760:Pyrrolidinones / Q000009:adverse effects* / Q000627:therapeutic use; D000068898:Raltegravir Potassium; D019562:Viral Load
D011760:Pyrrolidinones; D000068898:Raltegravir Potassium; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase