{"id":581,"date":"2008-08-30T17:58:13","date_gmt":"2008-08-30T16:58:13","guid":{"rendered":"http:\/\/localhost\/new\/htb\/?p=581"},"modified":"2013-08-27T16:05:58","modified_gmt":"2013-08-27T16:05:58","slug":"case-study-of-multi-drug-resistant-woman-receiving-newer-antiretroviral-drugs-in-pregnancy","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/581","title":{"rendered":"Case study of multi-drug resistant woman receiving newer antiretroviral drugs in pregnancy"},"content":{"rendered":"<p><strong>Polly Clayden, HIV i-Base<\/strong><\/p>\n<p><strong>A poster from Furco and coworkers from Northwick Park Hospital, Harrow, St Mary&#8217;s Hospital, London and Chelsea and Westminster Hospital, London reported a case study of a multi-drug resistant HIV-positive pregnant woman receiving a combination of newer antiretroviral drugs.<\/strong><\/p>\n<p>This patient was a 38-year-old African woman, pregnant with twins, who presented with a viral load of 4,660 copies\/mL and CD4 count 471 cells\/mm<sup>3<\/sup>) in early trimester.<\/p>\n<p>She had previously been treated with different combinations of NRTIs (5), NNRTIs (2) and protease inhibitors (2). Genotypic sequencing showed the following mutations &#8211; RT: D67N, V118I\/V, M184V, Y188L, L210W, T215Y; protease: L10I, I13V, G16E, K20I, M36I, M46I, I47V, F53L, I54V, D60E, D63T, H69K, I84V, L89M. A confirmatory phenotypic test showed high-level antiretroviral resistance.<\/p>\n<p>At 25 weeks gestation, she received a combination of tenofovir\/emtricitabine, darunavir\/ritonavir, etravirine and enfuvirtide. After 4 weeks her viral load was undetectable (&lt;50 copies\/mL).<\/p>\n<p>PK studies for enfuvirtide, etravirine and darunavir were performed and all drug concentrations were within the expected therapeutic ranges.<\/p>\n<p>At 34 weeks, her viral load was still undetectable and she delivered two HIV negative infants by caesarean section.<\/p>\n<p>The infants received ARV prophylaxis with enfuvirtide, nevirapine and ddI. The investigators noted that enfurvirtide was undetectable and darunavir\/ritonavir and etravirine were detectable in cord blood. The infants&#8217; adverse events included injection site reactions, hypertriglyceridaemia, anaemia, transient hypereosinophilia and raised alanine transferase.<\/p>\n<p class=\"ref\">Reference:<\/p>\n<p class=\"ref\">Furco A, Gosrani B, Nicholas S et al. Use of newer antiretroviral (ARV) drugs (darunavir, etravirine and enfuvirtide) in HIV-positive pregnant woman with pan-class resistance failure. 14th Annual BHIVA Conference, Dublin, 2008. HIV Medicine, 9 Suppl. 1. P60.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Polly Clayden, HIV i-Base A poster from Furco and coworkers from Northwick Park Hospital, Harrow, St Mary&#8217;s Hospital, London and Chelsea and Westminster Hospital, London reported a case study of a multi-drug resistant HIV-positive pregnant woman receiving a combination of &hellip;<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4,35],"tags":[50],"class_list":["post-581","post","type-post","status-publish","format-standard","hentry","category-conference-reports","category-pmtct-and-maternal-health","tag-bhiva-14th-2008"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/581","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\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=581"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/581\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=581"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=581"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=581"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}