Steady-state pharmacokinetics in pregnant women prescribed ritonavir boosted fosamprenavir (FPV/RTV) to prevent HIV transmission were assessed in the second trimester, third trimester, and postpartum. Compared to postpartum, geometric mean amprenavir (APV, FPVs active metabolite) area under the plasma concentration-time curves (AUC) were 35% lower in the second trimester and 25% lower in the third trimester. Maternal APV concentrations were 9 – 15-fold above the mean APV protein-adjusted 50% inhibitory concentration for wild-type HIV. Median ratio of cord blood/maternal APV levels was 0.27 and all infants were HIV negative. FPV/RTV during pregnancy was well tolerated and led to virologic suppression.
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