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Antenatal atazanavir: a retrospective analysis of pregnancies exposed to atazanavir.

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.

Item Type: Article
Additional Information: © 2014 Miriam Samuel et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: Obstetrics & Reproductive Medicine, 0605 Microbiology, 1108 Medical Microbiology
SGUL Research Institute / Research Centre: Academic Structure > Infection and Immunity Research Institute (INII)
Journal or Publication Title: Infectious Diseases in Obstetrics and Gynecology
Article Number: 961375
ISSN: 1064-7449
Language: eng
Dates:
DateEvent
25 September 2014Published
PubMed ID: 25328370
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/107260
Publisher's version: https://doi.org/10.1155/2014/961375

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