Short Communication: Reduced Nevirapine Concentrations Among HIV-Positive Women Receiving Mefloquine for Intermittent Preventive Treatment for Malaria Control During Pregnancy

AIDS Research and Human Retroviruses
Richard E HaalandMeghna Desai

Abstract

Clinical trials demonstrated intermittent preventive treatment in pregnancy with mefloquine (MQ) reduced malaria rates among pregnant women, yet an unexpected higher risk of mother-to-child transmission (MTCT) of HIV among HIV-positive women receiving MQ has also been observed. To determine if interactions between antiretroviral drugs (ARVs) and MQ could contribute to the increased MTCT observed in women receiving MQ, we performed a retrospective cross-sectional analysis of ARV plasma concentrations in peripheral blood (maternal plasma) and cord blood (cord plasma) collected at delivery from 186 mothers participating in a randomized clinical trial of MQ (n = 102) compared with placebo (n = 84) in Kenya. Plasma zidovudine (AZT), lamivudine (3TC), and nevirapine (NVP) concentrations were measured by high-performance liquid chromatography-tandem mass spectrometry. Although only 4% (7/186) reported not using these ARVs, AZT, 3TC, and NVP were all below the limit of detection in 44% of maternal plasma and 42% of cord plasma samples, and proportions were similar between the two study arms. Median concentrations of AZT and 3TC were not significantly lower in the MQ arm compared with the placebo arm for maternal plasma and cord plasma ...Continue Reading

References

Feb 1, 1993·Antimicrobial Agents and Chemotherapy·S H CheesemanJ J Keirns
Jun 26, 2001·British Journal of Clinical Pharmacology·Y KhaliqA McCarthy
Aug 19, 2008·Transactions of the Royal Society of Tropical Medicine and Hygiene·Chigozie J Uneke, Anayo Ogbonna
Feb 6, 2018·The Lancet Infectious Diseases·Umberto D'AlessandroEsperanca Sevene

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Apr 10, 2020·Expert Opinion on Drug Metabolism & Toxicology·Megan NearyAdeniyi Olagunju
Jul 31, 2020·Expert Opinion on Drug Metabolism & Toxicology·Brioni R Moore, Timothy M Davis

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