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Is infant exposure to antiretroviral drugs during breastfeeding quantitatively important? A systematic review and meta-analysis of pharmacokinetic studies.

Waitt CJ, Garner P, Bonnett LJ, Khoo SH, Else LJ - J. Antimicrob. Chemother. (2015)

Bottom Line: NNRTI estimates were from 0.71 to 0.94 (17 studies, 965 paired samples) and PI estimates were from 0.17 to 0.21 (8 studies, 477 paired samples).Relative to the recommended paediatric doses, a breast-fed infant may ingest 8.4% (95% CI 1.9-15.0), 12.5% (95% CI 2.6-22.3) and 1.1% (95% CI 0-3.6) of lamivudine, nevirapine and efavirenz, respectively, via BM.Transfer to untreated infants appears quantitatively important for some NRTIs and NNRTIs.

View Article: PubMed Central - PubMed

Affiliation: Department of Molecular and Clinical Pharmacology, University of Liverpool, Block A, The Waterhouse Buildings, 1-5 Brownlow Street, Liverpool L69 3GE, UK cwaitt@liv.ac.uk.

No MeSH data available.


Related in: MedlinePlus

Forest plot of IP : BM ratios for all drugs where infant concentrations were detectable, grouped according to drug class. Where studies reported drug levels at different infant ages, these are represented as a separate line. Pooled statistics are shown by the diamond and the I2 statistic is indicated. EFV, efavirenz; NVP, nevirapine; 3TC, lamivudine; ZDV, zidovudine; LPV, lopinavir; RTV, ritonavir; NR, not reported; NA, not available. *Conference proceeding.
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DKV080F5: Forest plot of IP : BM ratios for all drugs where infant concentrations were detectable, grouped according to drug class. Where studies reported drug levels at different infant ages, these are represented as a separate line. Pooled statistics are shown by the diamond and the I2 statistic is indicated. EFV, efavirenz; NVP, nevirapine; 3TC, lamivudine; ZDV, zidovudine; LPV, lopinavir; RTV, ritonavir; NR, not reported; NA, not available. *Conference proceeding.

Mentions: The ARV concentrations in MP and BM and the corresponding BM : MP ratios for each class of drug are summarized in Figures 2–4. Data on infant ARV concentrations resulting from BM exposure are summarized in Figure 5. Figure 6 illustrates the percentage of recommended infant dose ingested by a fully breast-fed 3 kg infant; results for other weights were similar and are not presented here.Figure 2.


Is infant exposure to antiretroviral drugs during breastfeeding quantitatively important? A systematic review and meta-analysis of pharmacokinetic studies.

Waitt CJ, Garner P, Bonnett LJ, Khoo SH, Else LJ - J. Antimicrob. Chemother. (2015)

Forest plot of IP : BM ratios for all drugs where infant concentrations were detectable, grouped according to drug class. Where studies reported drug levels at different infant ages, these are represented as a separate line. Pooled statistics are shown by the diamond and the I2 statistic is indicated. EFV, efavirenz; NVP, nevirapine; 3TC, lamivudine; ZDV, zidovudine; LPV, lopinavir; RTV, ritonavir; NR, not reported; NA, not available. *Conference proceeding.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4472329&req=5

DKV080F5: Forest plot of IP : BM ratios for all drugs where infant concentrations were detectable, grouped according to drug class. Where studies reported drug levels at different infant ages, these are represented as a separate line. Pooled statistics are shown by the diamond and the I2 statistic is indicated. EFV, efavirenz; NVP, nevirapine; 3TC, lamivudine; ZDV, zidovudine; LPV, lopinavir; RTV, ritonavir; NR, not reported; NA, not available. *Conference proceeding.
Mentions: The ARV concentrations in MP and BM and the corresponding BM : MP ratios for each class of drug are summarized in Figures 2–4. Data on infant ARV concentrations resulting from BM exposure are summarized in Figure 5. Figure 6 illustrates the percentage of recommended infant dose ingested by a fully breast-fed 3 kg infant; results for other weights were similar and are not presented here.Figure 2.

Bottom Line: NNRTI estimates were from 0.71 to 0.94 (17 studies, 965 paired samples) and PI estimates were from 0.17 to 0.21 (8 studies, 477 paired samples).Relative to the recommended paediatric doses, a breast-fed infant may ingest 8.4% (95% CI 1.9-15.0), 12.5% (95% CI 2.6-22.3) and 1.1% (95% CI 0-3.6) of lamivudine, nevirapine and efavirenz, respectively, via BM.Transfer to untreated infants appears quantitatively important for some NRTIs and NNRTIs.

View Article: PubMed Central - PubMed

Affiliation: Department of Molecular and Clinical Pharmacology, University of Liverpool, Block A, The Waterhouse Buildings, 1-5 Brownlow Street, Liverpool L69 3GE, UK cwaitt@liv.ac.uk.

No MeSH data available.


Related in: MedlinePlus