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In late 2007, the U.S. Public Health Service released updated guidelines for the prevention of perinatal HIV transmission (ACC Jan 14 2008). However, few new recommendations could be made at the time because of the continuing lack of information about the use of certain antiretrovirals during pregnancy. Fortunately, some new data became available at the 15th Retrovirus Conference.
Boosted PIs are used widely during pregnancy, in part because efavirenz is contraindicated during pregnancy and warnings exist about the use of nevirapine in women with CD4 counts >250 cells/mm3. However, plasma levels of some PIs, such as lopinavir/ritonavir, are thought to be reduced during pregnancy, and pharmacokinetic data are sorely lacking for oth…