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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Suboptimal nevirapine steady-state pharmacokinetics during intrapartum compared with postpartum in HIV-1-seropositive Ugandan women
Journal of Acquired Immune Deficiency Syndromes, Volume 55, No. 3, Year 2010
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Description
Background: Conflicting data exist regarding the effect of pregnancy on steady-state nevirapine pharmacokinetics (PK), although steady-state nevirapine concentrations during pregnancy have never been characterized in sub-Saharan Africa. Methods: This was a longitudinal intensive PK study in Ugandan pregnant women receiving nevirapine-based antiretroviral therapy. Participants underwent intensive 12-hour PK sampling during the second trimester (T2; n = 4), third trimester (T3; n = 15) and 6 weeks postpartum (PP; n = 15). HIV-1 RNA was performed within 2 weeks of each visit. Nevirapine C12 above 3000 ng/mL was classified as optimal based on the suggested value for therapeutic drug monitoring. Results: The pharmacokinetics of nevirapine were influenced by pregnancy, demonstrated by a 20% reduction in the maximum concentration, minimum concentration (C12), and area under the curve between T3 and PP visits (P = 0.001, P = 0.011 and P = 0.005, respectively). Ten subjects (66.7%) had C12 values <3000 ng/mL during T3. Of these participants, 7 partcipant's C12 concentrations increased to >3000 ng/mL during the PP visit. HIV-1 RNA were <1000 copies per milliliter at T3 and <400 copies per milliliter at PP in all patients. Conclusions: Nevirapine exposure was reduced in Ugandan women during their third trimester compared with the same women PP, however, HIV RNA remained <1000 copies per milliliter. The long-term impact of intermittent suboptimal nevirapine concentrations during pregnancy is unknown. © 2010 by Lippincott Williams & Wilkins.
Authors & Co-Authors
Lamorde, Mohammed
Uganda, Kampala
Makerere University
Ireland, Dublin
Trinity College Dublin
Byakika-Kibwika, Pauline
Uganda, Kampala
Makerere University
Ireland, Dublin
Trinity College Dublin
Uganda, Kampala
Infectious Diseases Network for Treatment and Research in Africa Interact
Okaba-Kayom, Violet
Uganda, Kampala
Makerere University
Flaherty, John P.
United States, Chicago
Northwestern University Feinberg School of Medicine
Boffito, Marta A.
United Kingdom, London
Chelsea and Westminster Hospital
Namakula, Rhoda
Uganda, Kampala
Makerere University
Ryan, Máirín A.A.
Ireland, Dublin
Trinity College Dublin
Nakabiito, Clemensia
Uganda, Kampala
Makerere University
Back, David J.
United Kingdom, Liverpool
University of Liverpool
Khoo, Saye Hock
United Kingdom, Liverpool
University of Liverpool
Merry, Concepta
Uganda, Kampala
Makerere University
Ireland, Dublin
Trinity College Dublin
Uganda, Kampala
Infectious Diseases Network for Treatment and Research in Africa Interact
Ireland, Dublin
St James's Hospital
Scarsi, Kimberly K.
Uganda, Kampala
Infectious Diseases Network for Treatment and Research in Africa Interact
Statistics
Citations: 23
Authors: 12
Affiliations: 7
Identifiers
Doi:
10.1097/QAI.0b013e3181e9871b
ISSN:
15254135
Research Areas
Infectious Diseases
Maternal And Child Health
Sexual And Reproductive Health
Study Design
Cohort Study
Participants Gender
Female