怀孕和哺乳期妇女使用PrEP的安全监测
Lee Fairlie1, Diane Lavies2, Emma Kalk2
1Wits RHI, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Frontiers in reproductive health
|October 19, 2023
概括
孕妇面临更高的艾滋病毒风险. 新的暴露前预防 (PrEP) 选择正在出现,但它们在怀孕和母乳养期间的安全性需要强大的监测系统,以确保母亲和儿童的福祉.
科学领域:
- 公共卫生 公共卫生
- 传染性疾病 传染性疾病
- 药物监督 药物监督 药物监督
背景情况:
- 怀孕和产后期增加了感染艾滋病毒的风险.
- 新获得的母性艾滋病毒增加了由于高病毒载量的垂直传播风险.
- 暴露前预防 (PrEP) 对于减少艾滋病毒感染至关重要.
研究的目的:
- 审查目前PrEP药物的安全性概况,适用于生育,怀孕和哺乳期妇女.
- 讨论在艾滋病流行性低收入和中等收入国家 (LMICs) 进行PrEP安全监测的务实方法.
主要方法:
- 对口服天诺福维尔/emtricitabine (TDF/FTC),天诺福维尔阿拉芬胺 (TAF) /FTC,长效卡博特格拉维尔 (CAB-LA) 和达皮维林环 (DVR) 的现有安全数据的审查.
- 讨论药物监测策略,包括被动和主动监测,以评估不良分娩结果.
- 考虑怀孕流行病学对稳健安全数据的要求.
主要成果:
- 对于大多数新型PrEP药物 (口服TDF/FTC除外) 在孕妇和哺乳期妇女的安全性数据有限.
- 没有感染艾滋病毒的孕妇对PrEP的安全风险胃口低于接受治疗的感染艾滋病毒的妇女.
- 需要全面的安全监测系统来监测孕妇群体的PrEP使用情况.
结论:
- 对于在怀孕和母乳养期间使用的新型PrEP药物,严格的安全监测至关重要.
- 监测必须识别,测量和保证对母亲,胎儿,婴儿和儿童的风险.
- 对于艾滋病毒流行性LMICs,需要实用性的监测方法,以告知政策并确保安全.
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