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首页> 外文期刊>The Canadian journal of hospital pharmacy. >Possible Atazanavir-lnduced Cholelithiasis in a Pregnant Woman: A Case Report
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Possible Atazanavir-lnduced Cholelithiasis in a Pregnant Woman: A Case Report

机译：可能的Atazanavir诱导的孕妇胆石病：案例报告

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INTRODUCTION: For treatment-naive adult patients infected with HIV, the first-line antiretroviral regimen consists of 2 nucleoside reverse transcriptase inhibitors in combination with an inte-grase inhibitor or a boosted darunavir regimen. As of April 2015, the US Department of Health and Human Services replaced atazanavir with an alternative protease inhibitor regimen in its guidelines for adults and adolescents. However, the most recent update (in August 2015) of the same organization's perinatal guidelines confirmed that during pregnancy, ritonavir-boosted atazanavir is still considered a first-line protease inhibitor option, because there has been extensive experience in this clinical setting with no adverse infant outcomes. Atazanavir has been associated, in both adult and pediatric populations, with unconjugated hyperbilirubinemia, a phenomenon that usually occurs without clinical complications. In one retrospective study involving 155 pregnant women who were exposed to atazanavir, the drug was reported to be generally well tolerated, with 63.2% of the patients reporting no side effects. Nausea was the most commonly observed adverse event (in 34.2% of patients), and about 2% of the women stopped treatment because of side effects. Cholelithiasis was not reported in phase III clinical trials of ritonavir-boosted atazanavir. However, recent postmarketing reports have suggested a potential association between this regimen and cholelithiasis. Here, we describe a case of cholelithiasis in a pregnant woman who was taking ritonavir-boosted atazanavir. To our knowledge, this is the first reported case of this form of toxicity during pregnancy.
机译：介绍：对于幼虫感染的治疗幼稚成年患者，第一线抗逆转录病毒方案由2个核苷逆转录酶抑制剂组合，与嵌入血液抑制剂或增强的达尔努纳夫方案组合。截至2015年4月，美国卫生和人类服务部门用替代蛋白酶抑制剂方案的成人和青少年准则取代了Atazanavir。然而，最近的更新（2015年8月）的围产期指导方针证实，在怀孕期间，Ritonavir-Boosted Atazanavir仍然被认为是一线蛋白酶抑制剂选择，因为在这种临床环境中存在广泛的经验，没有不利婴儿结果。 Atazanavir在成人和儿科群体中都与未经舒适的高胆血清血症有关，这种现象通常在没有临床并发症的情况下发生。在一项回顾性研究中，涉及接触到Atazanavir的155名孕妇，据报道，该药物普遍耐受，63.2％的患者报告没有副作用。恶心是最常见的不良事件（34.2％的患者），约有2％的女性因副作用而停止治疗。在Ritonavir-Boosted Atazanavir的III期临床试验中没有报告胆石病。但是，最近的上市报告表明该方案和胆石病之间存在潜在的关系。在这里，我们描述了一名孕妇中的胆石病，他正在服用ritonavir-boosted atazanavir。据我们所知，这是怀孕期间第一个据报道这种毒性的案例。

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