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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Antiretroviral-associated toxicity among HIV-1-seropositive pregnant women in Mozambique receiving nevirapine-based regimens
Journal of Acquired Immune Deficiency Syndromes, Volume 44, No. 4, Year 2007
Notification
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Description
OBJECTIVE: To assess toxicities associated with highly active antiretroviral therapy (HAART) among HIV-1-infected pregnant women treated with nevirapine-based regimens according to Mozambican national guidelines. STUDY DESIGN: Prospective cohort study. METHODS: HIV-1-infected antiretroviral-naive pregnant women with CD4 counts ≤350 cells/μL were initiated on nevirapine, lamivudine, and stavudine or zidovudine and followed monthly. Severe hepatotoxicity was defined as aspartate aminotransferase (AST) or alanine aminotransferase (ALT) levels ≥5-fold the upper limit of normal. Analyses were stratified by baseline CD4 count (<250 vs. 250-350 cells/μL). RESULTS: Among 146 pregnant women, 75 (52%) began nevirapine, lamivudine, and zidovudine and 71 (48%) began nevirapine, lamivudine, and stavudine. Overall, 79 (54%) women had CD4 counts <250 cells/μL, 7 (5%) had grade II hepatotoxicity, and 4 (3%) had severe (grade III or IV) hepatotoxicity. All 4 women with severe hepatotoxicity had baseline CD4 counts >250 cells/μL (P = 0.02). Rates of skin toxicity, anemia, and peripheral neuropathy did not differ by CD4 cell count group. Overall, 12 (8%) women changed or discontinued HAART as a result of drug toxicity. CONCLUSIONS: Severe hepatotoxicity from nevirapine-containing HAART in this cohort of pregnant women was more common at higher CD4 counts (6% vs. 0% among women with CD4 counts ≥250 cells/μL and CD4 counts <250 cells/μL, respectively), suggesting that laboratory monitoring is necessary when administering nevirapine-containing regimens to pregnant women with CD4 counts ≥250 cells/μL. © 2007 Lippincott Williams & Wilkins, Inc.
Authors & Co-Authors
Jamisse, Lilia
Mozambique, Maputo
Ministry of Health Mozambique
United States, Seattle
University of Washington
Balkus, Jennifer E.
United States, Seattle
University of Washington
Hitti, Jane E.
United States, Seattle
University of Washington
Gloyd, Stephen S.
United States, Seattle
University of Washington
Manuel, Rolanda Carmen Rafael
Mozambique, Maputo
Ministry of Health Mozambique
Osman, Nafissa Bique
Mozambique, Maputo
Hospital Central de Maputo
Djedje, Martinho
Mozambique, Maputo
Ministry of Health Mozambique
Farquhar, Carey
United States, Seattle
University of Washington
Statistics
Citations: 72
Authors: 8
Affiliations: 3
Identifiers
Doi:
10.1097/QAI.0b013e318032bbee
ISSN:
15254135
Research Areas
Infectious Diseases
Study Design
Cohort Study
Study Approach
Quantitative
Study Locations
Mozambique
Participants Gender
Female