孕期的药理动力学适应:对优化艾滋病毒阳性妇女抗逆转录病毒疗法的影响
Natalia Briceño-Patiño1,2, María Camila Prieto1, Paula Manrique1
1School of Medicine and Health Sciences, Universidad del Rosario, Bogota 111221, Colombia.
Pharmaceutics
|July 30, 2025
概括
怀孕改变了抗逆转录病毒治疗 (ART) 的药理学,可能会降低艾滋病毒阳性女性的药物水平. 量身定制的ART治疗方案和治疗药物监测对于维持病毒抑制和预防母婴艾滋病毒传播至关重要.
科学领域:
- 药理学 药理学是指药理学的学科.
- 传染性疾病 传染性疾病
- 孕产妇健康 孕产妇健康
背景情况:
- 怀孕显著改变药物药理动力学 (PK),影响HIV阳性女性抗逆转录病毒治疗 (ART) 的安全性和有效性.
- 优化ART对母体病毒抑制和预防母婴艾滋病毒传播 (MTCT) 至关重要.
研究的目的:
- 审查妊娠诱导的PK变化对ART的影响.
- 建议针对量身定制的ART治疗方案的策略,以改善怀孕,艾滋病毒阳性个体的治疗结果.
主要方法:
- 综合文献综述,重点关注怀孕期间的ART PK适应.
- 对不同ART类 (PI,INSTIs,NRTI) 药物暴露,疗效和安全性的关键研究进行分析.
主要成果:
- 怀孕通过增加新陈代谢,清除和改变蛋白质结合来改变ART PK,往往减少药物暴露.
- 一些ART,如洛皮纳维尔和阿塔扎纳维尔,需要调整剂量;其他,如多卢特格拉维尔,尽管水平较低,但仍然保持有效性.
- 整合酶抑制剂显示出良好的疗效,但增强方案可能具有次治疗水平.
结论:
- 孕期特定的PK变化需要基于证据的ART调整以抑制病毒和降低MTCT风险.
- 治疗药物监测 (TDM),药物基因组学和优先考虑安全是个性化ART的关键.
- 需要对长效ART和指南协调进行进一步的研究.
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