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Polly Clayden, HIV i-Base<\/strong><\/p>\n A systematic review of outcomes of infants born to women receiving lopinavir\/ritonavir (LPV\/r) in pregnancy – performed by investigators from the originator company – suggests that in utero exposure may not increase the risk of preterm birth.<\/strong><\/p>\n M Martinez presented data from an assessment of the vertical transmission rate and risk of adverse infant outcomes among women treated with LPV\/r based regimens in pregnancy at the 4th HIV & Women Workshop, 2014.<\/p>\n The investigators searched PubMed\/EMBASE databases and HIV conferences for studies published to the end of January 2013 or March 2013 respectively. They looked for randomised trials or prospective\/retrospective cohort studies of outcomes of infants exposed to LPV\/r in utero as a primary or secondary endpoint.<\/p>\n The investigators also searched the AbbVie Global Safety Database for the infant outcome of prematurity to the end of December 2011.<\/p>\n They included 27 publications (n=12) and abstract presentations (n=15) describing 17 studies in the review. These studies reported on 4331 women receiving LPV\/r in pregnancy, of these 2263 received LPV\/r 800\/200 mg\/day, 101 received >800\/200 mg\/day, and for 1967 the dose was undocumented. Table 1 shows the results.<\/p>\n Post-marketing safety data from the company database showed a preterm rate of 0.66\/10,000 patient treatment years for LPV\/r.<\/p>\n One study showed similar preterm, low birth weight and vertical transmission rates for women receiving 800\/200 mg and >800\/200 mg LPV\/r.<\/p>\n Three studies reporting birth defects showed a prevalence of 2% to 8.5%, which compared to the Antiretroviral Pregnancy Registry (APR) rate of 2.4%.<\/p>\n In one study the incidence of mortality among preterm infants was similar with LPV\/r based treatment to that for women treated with triple NRTIs.<\/p>\n The authors concluded: “Preterm birth rates in the included studies reflected the rate for the geographical area in which the study was conducted; these data and post-marketing safety data suggest that in utero exposure to LPV\/r may not increase risk of preterm birth. Infants born to women who received LPV\/r 800\/200 mg\/day and those born to women who received >800\/200 mg\/day had similar rates of preterm birth, low birth weight, and MTCT.”<\/p>\n Although analyses (particularly conclusions) performed by the originator company need to be approached with a little caution, these can be useful and results from this one supports the current APR data for LPV\/r.<\/strong><\/p>\n Reference:<\/p>\n Martinez M et al. Systematic review of clinical outcomes of infants born to women receiving lopinavir\/ritonavir-based antiretroviral therapy (ART) during pregnancy. 4th International Workshop on HIV & Women, Washington DC. 13-14 January 2014. Oral Abstract_21. Polly Clayden, HIV i-Base A systematic review of outcomes of infants born to women receiving lopinavir\/ritonavir (LPV\/r) in pregnancy – performed by investigators from the originator company – suggests that in utero exposure may not increase the risk of preterm …<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4,3,35,32],"tags":[185],"class_list":["post-24606","post","type-post","status-publish","format-standard","hentry","category-conference-reports","category-antiretrovirals","category-pmtct-and-maternal-health","category-paediatric-care","tag-intl-workshop-on-hiv-and-women-4th-2014"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/24606","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=24606"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/24606\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=24606"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=24606"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=24606"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}\n
\n Outcome<\/th>\n Studies reporting outcome (n)<\/th>\n Rate reported (%)<\/th>\n<\/tr>\n \n Vertical transmission<\/td>\n 10<\/td>\n 0 – 2.8<\/td>\n<\/tr>\n \n Preterm birth<\/td>\n 13<\/td>\n 8.7 – 25.0<\/td>\n<\/tr>\n \n Very preterm birth<\/td>\n 6<\/td>\n 0.4 – 5.0<\/td>\n<\/tr>\n \n Low birth weight<\/td>\n 6<\/td>\n 0.4 – 5.0<\/td>\n<\/tr>\n \n Very low birth weight<\/td>\n 4<\/td>\n 0.3 – 3.0<\/td>\n<\/tr>\n \n Still birth<\/td>\n 5<\/td>\n 1.0 – 4.8<\/td>\n<\/tr>\n \n Infant mortality<\/td>\n 4<\/td>\n 0 – 5.8<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n Comment<\/h3>\n
\nhttp:\/\/regist2.virology-education.com\/2014\/4hivwomen\/docs\/31_Martinez.pdf<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"