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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Antiretroviral prophylaxis for breastfeeding transmission in Malawi: Drug concentrations, virological efficacy and safety
Antiviral Therapy, Volume 17, No. 8, Year 2012
Notification
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Description
Background: Limited information is available on antiretroviral concentrations in women/infant pairs receiving prophylaxis for breastfeeding transmission of HIV and on the relationship between drug levels and the virological and haematochemistry parameters. Methods: Patient population included HIV-positive pregnant women receiving antiretroviral prophylaxis from gestational week 25 until 6 months after delivery and their breastfed infants. Blood and breast milk samples were collected at delivery, and at months 1, 3 and 6 postpartum. Drug concentrations were measured by liquid chromatography-mass spectrometry. Results: Overall, 66 women were studied: 29 received zidovudine (ZDV), lamivudine (3TC) and nevirapine (NVP), 28 stavudine (d4T), 3TC and NVP, and 9 ZDV, 3TC and lopinavir/ritonavir (LPV/r). Women who received >9 weeks of pre-partum prophylaxis were significantly more likely to have an undetectable viral load both in plasma and in breast milk at delivery. No emergence of resistance mutations was observed in breast milk. Breast milk/plasma concentration ratios were 0.6 for ZDV, 3TC and NVP, 1.0 for d4T and 0.4 for LPV/r. Only NVP reached significant levels in the infants. No correlation with any adverse events, including infant anaemia, was observed with drug concentrations. Two infants who acquired HIV infection had non-nucleoside reverse transcriptase inhibitor mutations at month 6. Conclusions: Maternal administration of these three regimens up to 6 months postpartum was effective and safe for both mothers and infants. No significant correlation was found between drug concentrations and infant haematological parameters, supporting the hypothesis that other factors may contribute to the development of anaemia in these settings. ©2012 International Medical Press.
Authors & Co-Authors
Palombi, Leonardo
Italy, Rome
Università Degli Studi Di Roma Tor Vergata
Italy, Rome
Dream Program
Pirillo, Maria Franca
Italy, Rome
Istituto Superiore Di Sanita
Andreotti, Mauro
Italy, Rome
Istituto Superiore Di Sanita
Liotta, Giuseppe
Italy, Rome
Università Degli Studi Di Roma Tor Vergata
Italy, Rome
Dream Program
Erba, Fulvio
Italy, Rome
Università Degli Studi Di Roma Tor Vergata
Italy, Rome
Dream Program
Sagno, Jean Baptiste
Malawi, Blantyre
Dream Program
Maulidi, Martin
Malawi, Blantyre
Dream Program
Ceffa, Susanna
Italy, Rome
Dream Program
Jere, Haswell
Malawi, Blantyre
Dream Program
Marchei, Emilia
Italy, Rome
Istituto Superiore Di Sanita
Pichini, Simona B.
Italy, Rome
Istituto Superiore Di Sanita
Galluzzo, Clementina Maria
Italy, Rome
Istituto Superiore Di Sanita
Vella, Stefano
Italy, Rome
Istituto Superiore Di Sanita
Giuliano, Marina
Italy, Rome
Istituto Superiore Di Sanita
Statistics
Citations: 38
Authors: 14
Affiliations: 5
Identifiers
Doi:
10.3851/IMP2315
ISSN:
13596535
e-ISSN:
20402058
Research Areas
Health System And Policy
Infectious Diseases
Maternal And Child Health
Study Design
Cross Sectional Study
Study Locations
Malawi
Participants Gender
Female