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Advancing research and development of anti-infectives for children with a focus on antiretroviral therapy: A clinical development perspective.
Int J Antimicrob Agents
October 2024
ViiV Healthcare, Brentford, Middlesex, UK. Electronic address:
The HIV treatment landscape for adults has progressed dramatically in recent decades; however, paediatric populations continue to experience delayed and limited access to effective and safe antiretroviral therapy options. Despite current incentive programmes, formulation research and development and approved drug dosing for children have been limited, particularly for neonates (aged <4 wk). Regulatory approval of drug formulations and dosing in children may lag behind adult approvals by years.
View Article and Find Full Text PDFComparison of dolutegravir and efavirenz on depression, anxiety and sleep disorders in pregnant and postpartum women living with HIV.
AIDS
June 2024
Radboud University Medical Center, Department of Pharmacy, Radboud Institute for Medical Innovations (RIMI), Nijmegen, the Netherlands.
Article Synopsis
- Both dolutegravir and efavirenz are effective treatments for preventing HIV transmission during pregnancy but may cause neuropsychiatric symptoms, which need further investigation in this population.
- A secondary analysis of the DolPHIN2 study assessed depression, anxiety, and sleep quality in 268 women who received either treatment late in pregnancy, showing notable rates of depression but no differences between the drug regimens.
- Findings indicate high initial depression scores that decreased over time, emphasizing the importance of psychological support for women diagnosed with HIV during pregnancy.
Facilitators and barriers to infant post-natal HIV prophylaxis, a qualitative sub-study of the PROMISE-EPI trial in Lusaka, Zambia.
Front Public Health
September 2023
Pathogenesis and Control of Chronic and Emerging Infections, Montpellier University, INSERM, EFS, CHU Montpellier, Montpellier, France.
Background: Infant post-natal prophylaxis (PNP) is used to prevent HIV transmission through breastfeeding. The WHO edited recommendations but so far there is no consensus on the duration of prophylaxis and the type of drug used depends on national guidelines. In Zambia, the national recommendations include a three-drug prophylaxis, composed of a dispersible combined tablet of zidovudine (AZT) and lamivudine (3TC) and an oral suspension of nevirapine (NVP) for 12 weeks or until the mother's viral load is <1,000 cp/mL.
View Article and Find Full Text PDFPost-Natal Anti-Retroviral Prophylaxis for Neonates Born to Mothers Living with Resistant HIV Infection.
Sultan Qaboos Univ Med J
August 2023
Infectious Diseases and Microbiology, The Children's Hospital at Westmead, Sydney, Australia.
Mother-to-child transmission accounts for the majority of new HIV infections among children worldwide. Post-natal prophylaxis, in addition to other preventive measures, have been very successful in reducing transmission to babies born to mothers living with HIV infection to <2%. Single-drug prophylaxis with zidovudine is the mainstay regimen for infants in low-risk transmission settings.
View Article and Find Full Text PDFPregnancy and neonatal safety outcomes of timing of initiation of daily oral tenofovir disoproxil fumarate and emtricitabine pre-exposure prophylaxis for HIV prevention (CAP016): an open-label, randomised, non-inferiority trial.
Lancet HIV
March 2023
South African Medical Research Council, Cape Town, South Africa.
Background: The safety of tenofovir disoproxil fumarate and emtricitabine as pre-exposure prophylaxis (PrEP) in pregnant women not living with HIV is uncertain. We aimed to compare pregnancy and neonatal outcomes in women exposed and not exposed to PrEP during pregnancy.
Methods: In this single-site, open-label, randomised, non-inferiority trial in Durban, South Africa, we evaluated pregnancy and neonatal outcomes in pregnant women aged 18 years or older, not living with HIV, and at 14-28 weeks' gestation at the time of enrolment.
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