title: Safety and efficacy of lopinavir/ritonavir during pregnancy: a systematic review.
abstract: The co-formulated, ritonavir-boosted protease inhibitor lopinavir is a frequently used component of HAART for treatment of HIV-infected women during pregnancy and prevention of mother-to-child transmission. We performed a systematic review to assess the effects of lopinavir/ritonavir on maternal and infant clinical and safety outcomes in HIV-infected pregnant women. PubMed, EMBASE, and select congresses were searched for studies published through May 31, 2012. Studies were selected that included HIV-infected pregnant mothers treated with a lopinavir/ritonavir-based regimen and described relevant maternal and infant outcomes. Ten articles or presentations describing nine studies were identified, comprising 2,675 lopinavir/ritonavir-treated women. In studies reporting HIV-1 RNA at delivery, HIV-1 RNA < 200 to < 1,000 copies/ml was achieved in 64-97% of subjects. Preterm delivery (< 37 weeks gestation) rates ranged from 8.3 to 25%; low birth weight (< 2,500 g) rates ranged from 11 to 20.3%. In one study, preterm delivery rates and low birth weight were similar between women who received standard or increased doses of lopinavir/ritonavir. In five studies reporting stillbirths and live births, 38 stillbirths occurred versus 2,058 live births (1.8%) among women receiving lopinavir/ritonavir. In eight studies reporting mother-to-child transmission at different time points, rates ranged from 0 to 3.3% and appeared to be similar in the one study comparing pregnant women who received standard or higher doses of lopinavir/ritonavir. The results from this systematic review suggest no unique safety or efficacy concerns with use of standard dose lopinavir/ritonavir as part of HAART in pregnant women.
authors: AbbVie Inc., 1 Waukegan Road, North Chicago, IL 60064, USA. mary.pasley@AbbVie.com
authors: Mary V
authors: MV
authors: Pasley
authors: Marisol
authors: M
authors: Martinez
authors: Ashwaq
authors: A
authors: Hermes
authors: Ronald
authors: R
authors: d'Amico
authors: Angela
authors: A
authors: Nilius
mesh_terms: D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology / Q000635:transmission; D015497:HIV-1 / Q000187:drug effects*; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D061466:Lopinavir / Q000008:administration & dosage*; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy* / Q000276:immunology / Q000517:prevention & control; D012367:RNA, Viral; D019438:Ritonavir / Q000008:administration & dosage*; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D012367:RNA, Viral; D061466:Lopinavir; D019438:Ritonavir