Pregnancy-related changes of antiretroviral pharmacokinetics: an argument for therapeutic drug monitoring

Antivir Ther. 2017;22(4):361-363. doi: 10.3851/IMP3122. Epub 2017 Jan 4.

Abstract

Here we describe a case of an HIV-infected young woman with extensive drug-resistant virus, who was successfully switched from a raltegravir-based regimen to a dolutegravir-based intensified antiretroviral regimen a few days before scheduled caesarean section because of the still detectable viral load. The trough concentrations of all antiretroviral drugs before and after delivery are also described. Our case underlines both the difficult management of young women, HIV-infected at young age with very limited treatment options and the great variability in the pregnancy-related physiological changes affecting the pharmacokinetics of antiretrovirals.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-HIV Agents / blood
  • Anti-HIV Agents / pharmacokinetics*
  • Anti-HIV Agents / pharmacology
  • Biological Availability
  • Cesarean Section
  • Drug Administration Schedule
  • Drug Monitoring*
  • Drug Resistance, Viral / drug effects
  • Drug Resistance, Viral / genetics
  • Drug Substitution*
  • Female
  • HIV Infections / blood
  • HIV Infections / drug therapy*
  • HIV Infections / virology
  • HIV-1 / drug effects
  • HIV-1 / enzymology
  • HIV-1 / growth & development
  • Heterocyclic Compounds, 3-Ring / blood
  • Heterocyclic Compounds, 3-Ring / pharmacokinetics*
  • Heterocyclic Compounds, 3-Ring / pharmacology
  • Humans
  • Mutation
  • Oxazines
  • Piperazines
  • Pregnancy
  • Pyridones
  • Raltegravir Potassium / blood
  • Raltegravir Potassium / pharmacokinetics*
  • Raltegravir Potassium / pharmacology
  • Viral Load / drug effects

Substances

  • Anti-HIV Agents
  • Heterocyclic Compounds, 3-Ring
  • Oxazines
  • Piperazines
  • Pyridones
  • Raltegravir Potassium
  • dolutegravir