title: Rapid reduction in HIV viral load in late pregnancy with raltegravir: a case report.
abstract: The use of raltegravir (RAL) is not preferred to prevent perinatal transmission in pregnancy due to lack of safety and pharmacokinetic data in this population. Data have been limited to few case reports of patients who present for treatment late in pregnancy, have multidrug resistance, or have poor adherence, requiring an additional class such as an integrase inhibitor to further lower viral load. This case report describes and supports the initiation of RAL in very late pregnancy (week 33) to rapidly decrease viral load and successfully prevent perinatal transmission. By increasing the efficacy and safety data of RAL use in pregnancy, we believe this report can help provide some guidance on the management of complex cases.
authors.affiliation: Division of Pharmacy Practice, Arnold & Marie Schwartz College of Pharmacy & Health Sciences, Brooklyn, NY, USA.
authors.forename: Agnes
authors.initials: A
authors.lastname: Cha
authors.forename: Raisa
authors.initials: R
authors.lastname: Shaikh
authors.forename: Shalonda
authors.initials: S
authors.lastname: Williams
authors.forename: Leonard L
authors.initials: LL
authors.lastname: Berkowitz
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000635:transmission / Q000821:virology*; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy* / Q000821:virology*; D011760:Pyrrolidinones / Q000627:therapeutic use*; D000068898:Raltegravir Potassium; D019562:Viral Load / Q000187:drug effects
chemical_list: D019380:Anti-HIV Agents; D011760:Pyrrolidinones; D000068898:Raltegravir Potassium
keywords: perinatal transmission; pregnancy; raltegravir