Atazanavir and lopinavir profile in pregnant women with HIV: Tolerability, activity and pregnancy outcomes in an observational national study

Marco Floridia, Marina Ravizza, Giulia Masuelli, Vania Giacomet, Pasquale Martinelli, Anna Degli Antoni, Arsenio Spinillo, Marta Fiscon, Daniela Francisci, Giuseppina Liuzzi, Carmela Pinnetti, Anna Maria Marconi, Enrica Tamburrini, F. Mori, P. Ortolani, E. R. Dalle Nogare, F. Di Lorenzo, G. Sterrantino, M. Meli, S. PolemiJ. Nocentini, M. Baldini, G. Montorzi, M. Mazzetti, P. Rogasi, B. Borchi, F. Vichi, B. Del Pin, E. Pinter, E. Anzalone, R. Marocco, C. Mastroianni, V. S. Mercurio, A. Carocci, E. Grilli, A. Maccabruni, M. Zaramella, B. Mariani, G. Natalini Raponi, G. Guaraldi, G. Nardini, C. Stentarelli, B. Beghetto, A. Molinari, M. P. Crisalli, A. Donisi, M. Piepoli, V. Cerri, G. Zuccotti, V. Fabiano, G. Placido, A. Vivarelli, P. Castelli, F. Savalli, V. Portelli, F. Sabbatini, L. Bernini, P. Grossi, L. Rizzi, S. Alberico, G. Maso, M. Airoud, G. Soppelsa, A. Meloni, M. Dedoni, C. Cuboni, F. Ortu, P. Piano, A. Citernesi, I. Bordoni Vicini, K. Luzi, M. Roccio, A. Vimercati, A. Miccolis, E. Bassi, B. Guerra, F. Cervi, C. Puccetti, P. Murano, M. Contoli, M. G. Capretti, C. Marsico, G. Faldella, M. Sansone, A. Agangi, C. Tibaldi, L. Trentini, T. Todros, V. Frisina, I. Cetin, T. Brambilla, V. Savasi, C. Personeni, C. Giaquinto, R. Rinaldi, E. Rubino, A. Bucceri, R. Matrone, G. Scaravelli, C. Fundarò, O. Genovese, C. Cafforio, V. Tozzi, P. Massetti, A. M. Casadei, A. F. Cavaliere, V. Finelli, M. Cellini, G. Castelli Gattinara, S. Dalzero, V. Sacchi, A. De Pirro, C. Polizzi, A. Mattei, M. F. Pirillo, R. Amici, C. M. Galluzzo, S. Donnini, S. Baroncelli, M. Regazzi, P. Villani, M. Cusato, A. Cerioli, M. De Martino, P. Mastroiacovo, M. Moroni, F. Parazzini, S. Vella

Research output: Contribution to journalArticle

Abstract

Background: Atazanavir and lopinavir represent the main HIV protease inhibitors recommended in pregnancy, but comparative data in pregnant women are limited. Methods: Women from a national observational study, exposed in pregnancy to either atazanavir or lopinavir, were compared for glucose and lipid profiles, liver function tests, CD4 count, HIV RNA and main pregnancy outcomes. Statistical methods included univariate and multivariable analyses. Results: The study population included 428 pregnancies (lopinavir, 322; atazanavir, 106). The lopinavir group was characterized by higher rates of HIV diagnosis in pregnancy and treatment indication for maternal health, lower CD4 counts, higher HIV RNA levels, less frequent antiretroviral treatment at conception and shorter duration of drug exposure during pregnancy. No differences in pregnancy outcomes, glucose metabolism and weight gain were observed. The two groups also showed in a multivariable analysis similar odds for detectable HIV RNA in the third trimester (adjusted OR 0.85, 95% CI 0.35-2.10, P1/40.730). Total lipid levels were significantly higher in the lopinavir group (median values in the third trimester 239 versus 221 mg/dL for total cholesterol and 226 versus 181 mg/dL for triglycerides; P

Original languageEnglish
Article numberdkt497
Pages (from-to)1377-1384
Number of pages8
JournalJournal of Antimicrobial Chemotherapy
Volume69
Issue number5
DOIs
Publication statusPublished - 2014

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Keywords

  • Bilirubin
  • Cholesterol
  • HIV RNA
  • Pre-term delivery
  • Triglycerides

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)
  • Infectious Diseases
  • Medicine(all)

Cite this

Floridia, M., Ravizza, M., Masuelli, G., Giacomet, V., Martinelli, P., Antoni, A. D., Spinillo, A., Fiscon, M., Francisci, D., Liuzzi, G., Pinnetti, C., Marconi, A. M., Tamburrini, E., Mori, F., Ortolani, P., Dalle Nogare, E. R., Di Lorenzo, F., Sterrantino, G., Meli, M., ... Vella, S. (2014). Atazanavir and lopinavir profile in pregnant women with HIV: Tolerability, activity and pregnancy outcomes in an observational national study. Journal of Antimicrobial Chemotherapy, 69(5), 1377-1384. [dkt497]. https://doi.org/10.1093/jac/dkt497