Nevirapine prophylaxis to prevent HIV-1 mother-to-child transmission: pharmacokinetic considerations in preterm infants.
Prophylaxis with zidovudine and 3 doses of nevirapine (NVP) is recommended for infants born to HIV-1 infected untreated mothers to prevent HIV-1 mother-to-child transmission. However little is known about NVP pharmacokinetics in neonates, mostly in preterm infants. We performed therapeutic monitoring of NVP plasma concentrations in a 32-week preterm HIV-1 exposed infant born to an infected untreated mother. With the recommended regimen, an intense NVP exposure was observed, with NVP plasma levels exceeding the target concentration by up to 40 times, suggesting that when a laboratory assessment of NVP plasma concentrations is available, it may be useful to monitor and optimize drug exposure.
Department of Obstetric, Gynaecological and Paediatric Sciences, Operative Unit of Neonatology, St. Orsola-Malpighi Hospital, University of Bologna, Italy.
Maria Grazia
MG
Capretti
Department of Obstetric, Gynaecological and Paediatric Sciences, Operative Unit of Neonatology, St. Orsola-Malpighi Hospital, University of Bologna, Italy.
Concetta
C
Marsico
Department of Oncology, Haematology and Laboratory Medicine, Central Laboratory, St. Orsola-Malpighi Hospital, University of Bologna, Italy.
Matteo
M
Conti
Department of Obstetric, Gynaecological and Paediatric Sciences, Operative Unit of Neonatology, St. Orsola-Malpighi Hospital, University of Bologna, Italy.
Luigi Tommaso
LT
Corvaglia
Department of Obstetric, Gynaecological and Paediatric Sciences, Operative Unit of Neonatology, St. Orsola-Malpighi Hospital, University of Bologna, Italy.
Santo
S
Arcuri
Department of Obstetric, Gynaecological and Paediatric Sciences, Operative Unit of Neonatology, St. Orsola-Malpighi Hospital, University of Bologna, Italy.
Giacomo
G
Faldella
Department of Experimental, Diagnostic and Specialty Medicine, Microbiology Section, St. Orsola-Malpighi Hospital, University of Bologna, Italy.
Maria Carla
MC
Re
D019380:Anti-HIV Agents / Q000493:pharmacokinetics / Q000627:therapeutic use; D005260:Female; D015658:HIV Infections / Q000517:prevention & control* / Q000635:transmission*; D015497:HIV-1; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D019829:Nevirapine / Q000493:pharmacokinetics* / Q000627:therapeutic use*; D009842:Oligopeptides / Q000627:therapeutic use; D011247:Pregnancy; D012367:RNA, Viral
D019380:Anti-HIV Agents; D009842:Oligopeptides; D012367:RNA, Viral; C090535:benzyloxycarbonyl-isoleucyl-glutamyl(O-tert-butyl)-alanyl-leucinal; D019829:Nevirapine
Antiretroviral prophylaxis; HIV-1 mother-to-child-transmission; Nevirapine; Preterm infants