Lopinavir Levels Are Low During Late Pregnancy

HIV-infected women on lopinavir/ritonavir have low levels of lopinavir during late pregnancy, raising the question of whether dosage should be increased.

Lopinavir/ritonavir (LPV/r) is commonly used in pregnant women to treat HIV and to prevent transmission of the virus to the infant. Physiologic changes during pregnancy can affect drug levels, potentially altering LPV’s antiviral effectiveness. As part of a multicenter, prospective study of the pharmacokinetics of currently prescribed antiretrovirals among pregnant HIV-infected women, the Pediatric AIDS Clinical Trials Group examined LPV levels in 17 women who were taking LPV/r during the third trimester of pregnancy. Participants took the standard dose of LPV/r capsules — 400/100 mg — twice daily.

Only 3 of the 17 women (18%) had LPV levels ≥52 μg h/mL, the estimated 10th percentile area under the curve for this drug in nonpregnant adults. …

Reviewing Author

Rajesh T. Gandhi, MD

Lopinavir Levels Are Low During Late Pregnancy

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Reviewing Author