Myelomeningocele in a child with intrauterine exposure to efavirenz

Fundarò, C.; Genovese, Orazio; Rendeli, Claudia; Tamburrini, Enrica; Salvaggio, E

doi:10.1097/00002030-200201250-00025

Cited by 132 publications

(48 citation statements)

References 3 publications

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“…NNRTIs are also associated with the occurrence of several conditions. Efavirenz has shown to be teratogenic [50] and should be avoided by women who are or might become pregnant. Efavirenz has also shown to cause short-term toxic effects to the CNS.…”

Section: Fusion Inhibitorsmentioning

confidence: 99%

“…[126] In a subsequent study, Zhang et al determined that statistical copolymers consisting of mannose-and diethylene glycol ethyl ether acrylate exhibited a higher affinity for DC-SIGN than a sequence controlled hexablock copolymer, demonstrating that statistical arrangement of mannose side chains plays an important role in its interaction with DC-SIGN. In addition, the incorporation of oligoethylene glycol acrylate (40) as well as fucose derivatized acrylate proved to be detrimental to the affinity and IC 50 (inhibition of DC-SIGN binding). [127] Multivalent polymers with a degree of polymerization of ca.…”

Section: Polymeric Dc-sign Antagonistsmentioning

confidence: 99%

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Polymeric Anti‐HIV Therapeutics

Danial

Klok

2014

Macromolecular Bioscience

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The scope of this review is to highlight the application of polymer therapeutics in an effort to curb the transmission and infection of the human immunodeficiency virus (HIV). Following a description of the HIV life cycle, the use of approved antiretroviral drugs that inhibit critical steps in the HIV infection process is highlighted. After that, a comprehensive overview of the structure and inhibitory properties of polymeric anti‐HIV therapeutic agents is presented. This overview will include inhibitors based on polysaccharides, synthetic polymers, dendritic polymers, polymer conjugates as well as polymeric DC‐SIGN antagonists. The review will conclude with a section that discusses the applications of polymers and polymer conjugates as systemic and topical anti‐HIV therapeutics.

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Section: Fusion Inhibitorsmentioning

confidence: 99%

Section: Polymeric Dc-sign Antagonistsmentioning

confidence: 99%

Polymeric Anti‐HIV Therapeutics

Danial

Klok

2014

Macromolecular Bioscience

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“…An infant exposed to efavirenz in utero had a neural-tube defect [53]. No human pharmacokinetic data are available for efavirenz or delavirdine in pregnancy.…”

Section: Delavirdine and Efavirenzmentioning

confidence: 99%

Implications of gender and pregnancy for antiretroviral drug dosing

Best

Capparelli

2008

Current Opinion in HIV and AIDS

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Purpose of review-This review briefly outlines the influences of gender and pregnancy on drug disposition, and describes the available antiretroviral pharmacokinetic data and dosing recommendations in these groups.Recent findings-Recent studies in pregnant women continue to document altered exposure of different classes of drugs during pregnancy. While new information shows that tenofovir exposure is significantly decreased during pregnancy, the magnitude of the decrease will not likely necessitate dose changes, similar to other nucleoside reverse transcriptase inhibitors. In contrast, standard doses of lopinavir/ritonavir in the third trimester showed markedly decreased exposure, and higher doses of this co-formulated agent should be given to women during the third trimester. Likewise, nelfinavir exposure using the new 625-mg tablets is also decreased during pregnancy, and higher doses should be considered in the third trimester.Summary-The majority of antiretrovirals studied have altered pharmacokinetics during pregnancy. Understanding the extent of these changes is necessary to recommend dose changes during pregnancy when appropriate. The correct dose is critical to maintain efficacy and safety of these agents for both the mother and the fetus. Innovative study designs are needed to facilitate the study of antiretrovirals during pregnancy.

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“…EFV is contraindicated for women of child bearing potential because it is known to be teratogenic, causing neural tube defects [43][44][45]. The impact of the CYP2B6-G516T genotype on the incidence of neural tube defect is currently unknown; however, it is possible that the CYP2B6-G516T genotype, which is associated with altering the plasma EFV levels, may impact on the incidence of neural tube defect in infants whose mothers are exposed to higher levels of EFV during the early pregnancy.…”

Section: Cyp2b6 Genotype and Adverse Effects Associated With Nnrti Usementioning

confidence: 99%

Effect of Host Genetic Variation on the Pharmacokinetics and Clinical Response of Nnrtis

Saitoh

Spector

2007

Future HIV Ther.

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Non-nucleoside reverse transcriptase inhibitors (NNRTIs) have been used widely for treating human immunodeficiency virus type 1 (HIV-1) infected patients as a component of highly active antiretroviral therapy (HAART) and for the prevention of mother-to-child transmission (MTCT). Cytochrome P450 (CYP) 2B6 is an important hepatic isoenzyme responsible for the metabolism of NNRTIs including efavirenz and nevirapine. Recent pharmacogenetic studies have shown that CYP2B6 genetic variants alter hepatic CYP2B6 protein expression and function, and the pharmacokinetics of several CYP2B6 substrates. In particular, the CYP2B6-G516T polymorphism in exon 4 affects the pharmacokinetics of efavirenz. Other studies have shown associations of the CYP2B6-G516T genotype with nevirapine pharmacokinetics and central nervous system adverse effects related to efavirenz use. In total, CYP2B6 genetic variants are important determinants of efavirenz and nevirapine pharmacokinetics . Further studies are needed to identify the associations of CYP2B6 genetic variants with the development of NNRTI resistant viruses.

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Myelomeningocele in a child with intrauterine exposure to efavirenz

Cited by 132 publications

References 3 publications

Polymeric Anti‐HIV Therapeutics

Polymeric Anti‐HIV Therapeutics

Implications of gender and pregnancy for antiretroviral drug dosing

Effect of Host Genetic Variation on the Pharmacokinetics and Clinical Response of Nnrtis

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