当前意见:在怀孕和哺乳期间服用抗逆转录病毒药物
Laura Nijboer1, Lena van der Wekken-Pas1, Karoline Aebi-Popp2,3
1Department of Pharmacy, Radboud Institute for Medical Innovations (RIMI), Radboud University Medical Center, Nijmegen, The Netherlands.
Current opinion in HIV and AIDS
|November 8, 2024
概括
最近的研究表明,怀孕和母乳养期间的抗逆转录病毒药物水平通常对婴儿是安全的. 对比克特格拉维尔和长效配方的研究为母亲和婴儿健康提供了关键数据.
科学领域:
- 药理学 药理学是指药理学的学科.
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 传染性疾病 传染性疾病
背景情况:
- 抗逆转录病毒疗法 (ART) 对于孕妇的HIV管理至关重要.
- 了解药物的药理动力学,胎盘转移和婴儿暴露对于优化治疗和确保安全至关重要.
- 关于怀孕和哺乳期新型ART配方的数据有限.
研究的目的:
- 审查最近 (过去2年) 关于怀孕中的抗逆转录病毒药理学的文献.
- 评估常用抗逆转录病毒药物的胎盘转移和婴儿通过母乳暴露.
- 讨论in-silico和ex-vivo模型在这个研究领域的实用性.
主要方法:
- 关于过去两年发表的研究的文献综述.
- 对药物动力学数据的分析,包括药物度和胎盘转移.
- 包括ex-vivo (例如,胎盘 perfusion) 和in-silico (例如,PBPK模型) 的研究应用.
主要成果:
- 对于在怀孕期间经常使用的药物,呈现了抗逆转录病毒度和胎盘转移数据.
- 婴儿通过母乳接触的各种抗逆转录病毒药物被评估.
- 在怀孕期间,比克特格拉维尔的度降低但足够,这促使FDA更新了标签.
- 在和临床数据表明,在怀孕期间谨慎使用长效卡博特格拉维尔和里尔皮维林.
结论:
- 在生成关于怀孕和哺乳期抗逆转录病毒药物的数据方面取得了重大进展.
- 大多数抗逆转录病毒药物通过母乳对婴儿的暴露率很低.
- 需要早期的药物开发研究来为孕妇提供全面的信息.
- 持续的研究对于在孕妇和哺乳期的人群中知情地使用抗逆转录病毒药物至关重要.
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