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Therapeutic drug monitoring (TDM) of atazanavir in pregnancy
© Else et al; licensee BioMed Central Ltd. 2010
Published: 8 November 2010
Pregnant women experience physiological changes during pregnancy resulting in clinically significant alterations in antiretroviral pharmacokinetics (PK). Therefore, achieving and maintaining optimal plasma concentrations of antiretroviral drugs is essential for maternal health and minimising the risk of mother-to-child transmission of HIV.
Purpose of the study
To describe atazanavir/ritonavir (ATV/r) PK during pregnancy.
In this prospective, open labelled study, pregnant HIV-positive women received ATV/r as part of their routine pre-natal care. Demographic and clinical data were collected, and ATV plasma concentrations [ATV] were determined in the first (T1) and/or second (T2) and/or third (T3) trimester using HPLC-MS/MS (LLQ = 0.05 µg/mL). Postpartum (PP) sampling was performed where applicable. Antepartum (AP) and PP PK parameters were compared using a One-way ANOVA (for independent data sets) and a paired t-test (for paired data).
Summary of results
Time of sampling, h
Although ATV concentrations were reduced in the third trimester, standard ATV/r dosing did achieve therapeutic levels (>150 ng/mL) both antepartum and postpartum, suggesting the current regimen is appropriate in pregnancy.
This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.