title: Critical Review: Review of the Efficacy, Safety, and Pharmacokinetics of Raltegravir in Pregnancy.
abstract: Raltegravir was previously considered an alternative antiretroviral in pregnancy because of limited data, but recent pregnancy guidelines recommend raltegravir as a preferred integrase treatment option. Data from published articles and preliminary meeting reports between 2001 and July 2015 are reviewed. The literature includes a total of 278 maternal-infant pairs who received raltegravir during pregnancy. The standard raltegravir dose seems safe and effective in preventing mother-to-child transmission in late pregnancy presenters with unknown or unsuppressed viral load, or in multidrug resistance. Viral decay was rapid allowing most women to deliver at undetectable viral levels. Raltegravir was well tolerated, with the exception of a few cases of transient increases in maternal transaminases. No infant adverse effect was consistently reported. Existing data support the use of raltegravir in antiretroviral-naive and experienced pregnant women.
authors.affiliation: *Student at the Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada;†Currently, employee of Providence Healthcare, Toronto, Canada;‡Department of Medicine, University of Toronto, Toronto, Canada;§Division of Infectious Diseases, University Health Network, Toronto, Canada;‖Immunodeficiency Clinic, University Health Network, Toronto, Canada; and¶Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada.
authors.forename: Annabelle
authors.initials: A
authors.lastname: Maliakkal
authors.forename: Sharon
authors.initials: S
authors.lastname: Walmsley
authors.forename: Alice
authors.initials: A
authors.lastname: Tseng
mesh_terms: D019380:Anti-HIV Agents / Q000009:adverse effects / Q000493:pharmacokinetics* / Q000627:therapeutic use; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000276:immunology; D019428:HIV Integrase Inhibitors / Q000009:adverse effects / Q000493:pharmacokinetics* / Q000627:therapeutic use; D015497:HIV-1 / Q000187:drug effects*; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy* / Q000453:epidemiology / Q000276:immunology; D000068898:Raltegravir Potassium / Q000009:adverse effects / Q000493:pharmacokinetics* / Q000627:therapeutic use; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents; D019428:HIV Integrase Inhibitors; D000068898:Raltegravir Potassium