Therapeutic drug monitoring guided raltegravir dosing for prevention of vertical transmission in a premature neonate born to a woman living with perinatally acquired HIV

Denise Kreutzwiser; Nancy Sheehan; Natalie Dayneka; Benoît Lemire; Alison Wong; Lindy Samson; Jason Brophy

doi:10.3851/IMP3139

Therapeutic drug monitoring guided raltegravir dosing for prevention of vertical transmission in a premature neonate born to a woman living with perinatally acquired HIV

Antivir Ther. 2017;22(6):545-549. doi: 10.3851/IMP3139. Epub 2017 Feb 15.

Authors

Denise Kreutzwiser^{1

2

3}, Nancy Sheehan^{1

4

5}, Natalie Dayneka⁶, Benoît Lemire^{1

4}, Alison Wong^{1

4}, Lindy Samson^{6

7}, Jason Brophy^{6

7}

Affiliations

¹ McGill University Health Centre, Chronic Viral Illness Service, Montréal, QC, Canada.
² Toronto General Hospital, University Health Network, Immunodeficiency Clinic, Toronto, ON, Canada.
³ University of Toronto, Leslie Dan Faculty of Pharmacy, Toronto, ON, Canada.
⁴ McGill University Health Centre, Québec Antiretroviral Therapeutic Drug Monitoring Program, Montréal, QC, Canada.
⁵ Université de Montréal, Faculté de Pharmacie, Montréal, QC, Canada.
⁶ Children's Hospital of Eastern Ontario, Ottawa, ON, Canada.
⁷ Department of Pediatrics, University of Ottawa, Faculty of Medicine, Ottawa, ON, Canada.

PMID: 28198351
DOI: 10.3851/IMP3139

Abstract

We report a case of therapeutic drug monitoring guided raltegravir use for the prevention of vertical HIV transmission in a premature neonate born to a woman living with perinatally acquired HIV and documented resistance to multiple HIV drugs. Maternal viral load was above 1,000 copies/ml at delivery. This case demonstrates delayed raltegravir elimination in a neonate born at 33 weeks gestational age and a need for less frequent raltegravir dosing than is used in older infants and children.

Publication types

Case Reports

MeSH terms

Adult
Anti-HIV Agents / administration & dosage*
Anti-HIV Agents / pharmacokinetics
Antiretroviral Therapy, Highly Active
Drug Monitoring
Drug Resistance, Viral
Female
HIV Infections / diagnosis
HIV Infections / prevention & control*
HIV Infections / transmission*
HIV Infections / virology
Humans
Infant, Newborn
Infant, Premature*
Infectious Disease Transmission, Vertical / prevention & control*
Post-Exposure Prophylaxis
Pregnancy
Pregnancy Complications, Infectious
Raltegravir Potassium / administration & dosage*
Raltegravir Potassium / pharmacokinetics
Treatment Outcome
Viral Load

Substances

Anti-HIV Agents
Raltegravir Potassium