Potential effect of pharmacogenetics on maternal, fetal and infant antiretroviral drug exposure during pregnancy and breastfeeding

被引:0
|
作者
Olagunju, Adeniyi [2 ,3 ]
Owen, Andrew [3 ]
Creesey, Tim R. [1 ,4 ,5 ]
机构
[1] Chiang Mai Univ, Fac Associated Med Sci, Dept Med Technol, Program HIV Prevent & Treatment, Chiang Mai, Thailand
[2] Obafemi Awolowo Univ, Fac Pharm, Ife, Nigeria
[3] Univ Liverpool, Inst Translat Med, Liverpool L69 3BX, Merseyside, England
[4] Harvard Univ, Sch Publ Hlth, Boston, MA 02115 USA
[5] Inst Rech Dev, UMI 174, Marseille, France
基金
英国医学研究理事会;
关键词
antiretrovirals; drug transporters; highly active antiretroviral therapy; HIV; pregnancy; prevention of mother-to-child transmission; HUMAN-IMMUNODEFICIENCY-VIRUS; TO-CHILD TRANSMISSION; REVERSE-TRANSCRIPTASE INHIBITOR; HIV-INFECTED PATIENTS; TENOFOVIR DISOPROXIL FUMARATE; MULTIDRUG-RESISTANT HIV-1; CONSTITUTIVE ANDROSTANE RECEPTOR; NEVIRAPINE PLASMA-CONCENTRATIONS; STEADY-STATE PHARMACOKINETICS; AMNIOTIC-FLUID ACCUMULATION;
D O I
10.2217/PGS.12.138
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
Mother-to-child-transmission rates of HIV in the absence of any intervention range between 20 and 45%. However, the provision of antiretroviral drugs (ARVs) during pregnancy, delivery and breastfeeding can reduce HIV transmission to less than 2%. Physiological changes during pregnancy can influence ARV disposition. Associations between SNPs in genes coding for metabolizing enzymes, and/or transporters, and ARVs disposition are well described; however, relatively little is known E bout the influence of these SNPs on ARV pharmacokinetics during pregnancy and lactation as well as their effect on distribution into the fetal compartment and breast milk excretion. Differences in maternal, fetal and infant ARV exposure due to SNPs may affect the efficacy and safety of ARVs used to prevent mother-to-child-transmission. The aim of this review is to provide an update on the effect of pregnancy-induced changes on the pharmacokinetics of ARVs and highlight the potential role of pharmacogenetics.
引用
收藏
页码:1501 / 1522
页数:22
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