Samuel, M;
Bradshaw, D;
Perry, M;
Chan, SY;
Dhairyawan, R;
Byrne, L;
Smith, K;
Zhou, J;
Short, CE;
Naftalin, C;
et al.
Samuel, M; Bradshaw, D; Perry, M; Chan, SY; Dhairyawan, R; Byrne, L; Smith, K; Zhou, J; Short, CE; Naftalin, C; Offodile, N; Mandalia, S; Roedling, S; Shah, R; Brook, G; Poulton, M; Rodgers, M; Sarner, L; Noble, H; Hay, P; Anderson, J; Natha, M; Hawkins, D; Taylor, G; de Ruiter, A
(2014)
Antenatal atazanavir: a retrospective analysis of pregnancies exposed to atazanavir.
Infectious Diseases in Obstetrics and Gynecology, 2014.
ISSN 1064-7449
https://doi.org/10.1155/2014/961375
SGUL Authors: Hay, Phillip Edward
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Abstract
INTRODUCTION: There are few data regarding the tolerability, safety, or efficacy of antenatal atazanavir. We report our clinical experience of atazanavir use in pregnancy.
METHODS: A retrospective medical records review of atazanavir-exposed pregnancies in 12 London centres between 2004 and 2010.
RESULTS: There were 145 pregnancies in 135 women: 89 conceived whilst taking atazanavir-based combination antiretroviral therapy (cART), "preconception" atazanavir exposure; 27 started atazanavir-based cART as "first-line" during the pregnancy; and 29 "switched" to an atazanavir-based regimen from another cART regimen during pregnancy. Gastrointestinal intolerance requiring atazanavir cessation occurred in five pregnancies. Self-limiting, new-onset transaminitis was most common in first-line use, occurring in 11.0%. Atazanavir was commenced in five switch pregnancies in the presence of transaminitis, two of which discontinued atazanavir with persistent transaminitis. HIV-VL < 50 copies/mL was achieved in 89.3% preconception, 56.5% first-line, and 72.0% switch exposures. Singleton preterm delivery (<37 weeks) occurred in 11.7% preconception, 9.1% first-line, and 7.7% switch exposures. Four infants required phototherapy. There was one mother-to-child transmission in a poorly adherent woman.
CONCLUSIONS: These data suggest that atazanavir is well tolerated and can be safely prescribed as a component of combination antiretroviral therapy in pregnancy.
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