Integrase Inhibitors Use for HIV Infection in Pregnancy

Total, Unbound, Renal, and Hepatic Clearances of Raltegravir and the Formation and Elimination Clearances of Raltegravir Glucuronide in Pregnant Women

“…5 RAL is safe for pregnant women, and the most common adverse event is the presence of abnormal hemoglobin values when compared with average values during pregnancy. 5,6 A study from Brazil 7 did not find differences in the frequency of preterm birth, low birth weight, small for gestational age, stillbirths, or perinatal mortality between neonates whose mothers received RAL and those whose mothers received other evaluated treatments, including efavirenz, lopinavir/ritonavir, or atazanavir/ ritonavir. RAL pharmacokinetics are highly variable, 8 with secondary peaks often seen in plasma concentrations versus time profiles, probably due to enterohepatic recycling or delayed absorption.…”

“…In pregnant women who received RAL‐containing cART, 94% were virologically suppressed close to the time of delivery 5 . RAL is safe for pregnant women, and the most common adverse event is the presence of abnormal hemoglobin values when compared with average values during pregnancy 5,6 . A study from Brazil 7 did not find differences in the frequency of preterm birth, low birth weight, small for gestational age, stillbirths, or perinatal mortality between neonates whose mothers received RAL and those whose mothers received other evaluated treatments, including efavirenz, lopinavir/ritonavir, or atazanavir/ritonavir.…”