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11th Annual Conference Of The British HIV Association [BHIVA]20–23 April 2005, Burlington Hotel·Dublin·Ireland |
[AUTHOR(S):] S O’Dea1, F Mulcahy1, F Lyons1, H McDermott1, C Bergin1, S Coughlan2
1GUIDE Clinic, St James Hospital, Dublin, 2National Virus Reference Laboratory, University College Dublin, Ireland
BHIVA Conf 2005 Apr 20-23;11:O11
BACKGROUND: Sub-therapeutic levels of nelfinavir in pregnancy, at standard dosing, have been reported. This study examines viral response, resistance and outcome in a cohort of women receiving combivir/nelfinavir(standard doses) in pregnancy.
METHODS: 47 pregnant women with a pre-treatment CD4> 300×106/l were prescribed combivir/nelfinavir in the 3rd trimester. All received at least 6 weeks treatment (range 6–12, mean 11 weeks) and discontinued post-partum. All women returned for genotypic resistance testing after treatment cessation.
RESULTS: Viral load at 36 weeks: 26/47[55%] <50cpm; 18/47[38%] >50<1000cpm (mean 154cpm) and 3/47[6%] >1000cpm (mean 2160cpm). Mean pre-treatment VL 3,761cpm in <50 group versus 39,535cpm in >50 group. Adherence issues were identified in 4/26(15%) with 36 week VL<50cpm; 1/18(5.5%) with VL>50<1000cpm and 1/3(33%) with VL> 1000cpm. No drug A/Es were reported. No primary PI resistance mutations were identified after treatment cessation. 1 baby acquired HIV (maternal VL<50cpm, membranes ruptured >24hrs).
CONCLUSIONS: At standard nelfinavir dosing almost half the cohort failed to achieve virological suppression <50cpm, suggesting that routine TDM should be considered. Despite this, the absence of PI mutations after treatment cessation suggests that short-term nelfinavir use may not be detrimental to future maternal ART options.
PRESENTING AUTHOR: S O’Dea
2005-04-20
O11
Copyright © 2005 - British HIV Association (BHIVA) Reproduction of this abstract (other than one copy for personal reference) must be cleared through the BHIVA Organising Secretariat 1 Mountview Court, 310 Friern Barnet Lane, London N20 0LD