HIV Treatment Bulletin - Vol. 5, No. 7, August/September 2004

Polly Clayden, HIV i-Base

Pregnancy can alter the pharmacokinetics (PK) of antiretrovirals and it is well known that optimal exposure during pregnancy is essential both for maternal health and preventing mother to child transmission. In an oral late breaker, Alice Stek presented preliminary findings from a small sub study of PACTG 1026 – an ongoing study of PK in HIV-infected women.

This study compared data from intensive PK profiles (over 12 hours) performed at 30-36 weeks gestation obtained from 12 women receiving lopinavir/ritonavir 400/100mg twice daily to non-pregnant controls and to post partum measurements at 6-12 weeks (available for 4 women). Maternal and cord blood samples were also obtained at delivery.

Target LPV AUC was >10th percentile (52mcg*hr/mL) and the investigators reported that 10 of the 12 women did not reach this target – the average antepartum LPV AUC was 44+- 17mcg*hr/mg (95%CI 34-54). Of the 4 women for which post partum evaluations were available 1/4 did not reach the target LPV AUC. Maternal and cord blood samples were available for 5 maternal infant pairs and these revealed an average foetal exposure of 23% of maternal LPV concentration indicating that only small amounts of LPV appear to cross the placenta.

Findings from this small study suggest lower LPV exposure during the third trimester of pregnancy compared to non-pregnant controls and to post partum exposure. Dr Stek explained that this ongoing study would be modified to enrol women in the second trimester to investigate increased dosing of LPV/r in pregnancy.

Ref: Stek A, Mirochnick M, Capparelli E et al. Reduced lopinavir exposure during pregnancy: preliminary pharmacokinetic results from PACTG 1026. XV Intl AIDS Conference, Bangkok. Abstract LbOrB08.

040810
IB040507-08

©2004. I-BASE HIV Treatment Bulletin. Permission to reproduce courtesy of HIV i-Base, Third Floor East, Thrale House, 44-46 Southwark Street, London SE1 1UN - T: +44 (0) 20 7407 8488 F: +44 (0) 20 7407 8489

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted grants from Boehringer Ingelheim, Elton John AIDS Foundation, John M. Lloyd Foundation, the National Library of Medicine, and donations from users like you. Always watch for outdated information. This article first appeared in 2004. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2004. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content.