PDF(Pubmed)
Abstract：
Selection of antiretroviral therapy during pregnancy must consider maternal physiology and resulting pharmacokinetic changes in pregnancy, resistance and efficacy profiles, tolerability and frequency of adverse effects, teratogenicity, and maternal, neonatal, and pregnancy outcomes. The objective of this review is to summarize the underlying data that informs the current clinical perinatal guidelines in the USA.
Data now supports the use of dolutegravir at all stages of pregnancy with no significant increase in neural tube defects. Safety and pharmacokinetic data on newer antiretroviral medications in pregnancy continue to lag behind the general population. While there are multiple safety and tolerability concerns with older regimens, there are now multiple options of regimens that are highly efficacious and have good safety data in pregnancy. Most pregnant patients who are virally suppressed on a well-tolerated regimen are able to safely continue those medications during pregnancy.
Data now supports the use of dolutegravir at all stages of pregnancy with no significant increase in neural tube defects. Safety and pharmacokinetic data on newer antiretroviral medications in pregnancy continue to lag behind the general population. While there are multiple safety and tolerability concerns with older regimens, there are now multiple options of regimens that are highly efficacious and have good safety data in pregnancy. Most pregnant patients who are virally suppressed on a well-tolerated regimen are able to safely continue those medications during pregnancy.
摘要：
目的：选择妊娠期抗逆转录病毒治疗必须考虑母体生理和由此引起的妊娠药代动力学变化，抗性和功效概况，副作用的耐受性和频率，致畸性，和母亲，新生儿,和妊娠结局。本综述的目的是总结为美国当前临床围产期指南提供信息的基础数据。
结果：数据现在支持在怀孕的所有阶段使用dolutegravir，而神经管缺陷没有显着增加。怀孕期间新型抗逆转录病毒药物的安全性和药代动力学数据继续落后于普通人群。虽然旧方案存在多种安全性和耐受性问题，现在有多种方案可供选择,这些方案非常有效,并且在怀孕期间具有良好的安全性数据.大多数在耐受性良好的方案下受到病毒抑制的怀孕患者能够在怀孕期间安全地继续这些药物。
结果：数据现在支持在怀孕的所有阶段使用dolutegravir，而神经管缺陷没有显着增加。怀孕期间新型抗逆转录病毒药物的安全性和药代动力学数据继续落后于普通人群。虽然旧方案存在多种安全性和耐受性问题，现在有多种方案可供选择,这些方案非常有效,并且在怀孕期间具有良好的安全性数据.大多数在耐受性良好的方案下受到病毒抑制的怀孕患者能够在怀孕期间安全地继续这些药物。
