Tenofovir Pre-exposure Prophylaxis for Pregnant and Breastfeeding Women at Risk of HIV Infection: The Time is Now

In this Perspective, Lynne Mofenson discusses the implications of Mugwanya and colleagues' findings for protection of women against HIV infection during breastfeeding.

Vyšlo v časopise: Tenofovir Pre-exposure Prophylaxis for Pregnant and Breastfeeding Women at Risk of HIV Infection: The Time is Now. PLoS Med 13(9): e32767. doi:10.1371/journal.pmed.1002133
Kategorie: Perspective
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pmed.1002133


In this Perspective, Lynne Mofenson discusses the implications of Mugwanya and colleagues' findings for protection of women against HIV infection during breastfeeding.


1. Fonner VA, Dalglish SL, Kennedy CE, Baggaley R, O'Reilly KR, Koechlin FM, et al. Effectiveness and safety of oral HIV pre-exposure prophylaxis for all populations. AIDS. 2016 Jul 31;30(12):1973–83. doi: 10.1097/QAD.0000000000001145 27149090

2. World Health Organization. Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection—recommendations for a public health approach—second edition, 2016. Geneva, Switzerland: World Health Organization, 2016. http://www.who.int/hiv/pub/arv/arv-2016/en/.

3. Drake AL, Wagner A, Richardson B, John-Stewart G. Incident HIV during pregnancy and postpartum and risk of mother-to-child HIV transmission: a systematic review and meta-analysis. PLoS Med. 2014;11:e1001608. doi: 10.1371/journal.pmed.1001608 24586123

4. VIREAD drug label, revised 02/2016. Gilead, Foster City, CA, 2016. http://www.gilead.com/~/media/Files/pdfs/medicines/liver-disease/viread/viread_pi.pdf.

5. Mugwanya KK, Hendrix CW, Mugo NR, Marzinke M, Katabira ET, Ngure K, et al. Pre-exposure prophylaxis use by breastfeeding HIV-uninfected women: a prospective short-term study of antiretroviral excretion in breast milk and infant absorption. PLoS Med. 2016; 11:e1002133. doi: 10.1371/journal.pmed.1002133

6. Corbett AH, Kayira D, White NR, Davis NL, Kourtis AP, Chasela C, et al. Antiretroviral pharmacokinetics in mothers and breastfeeding infants from 6 to 24 weeks post-partum: results of the BAN Study. Antivir Ther. 2014;19:587–95. doi: 10.3851/IMP2739 24464632

7. Shapiro RL, Rossi S, Ogwu A, Moss M, Leidner J, Moffat C, et al. Therapeutic levels of lopinavir in late pregnancy and abacavir passage into breast milk in the Mma Bana Study, Botswana. Antivir Ther. 2013;18:585–90. doi: 10.3851/IMP2474 23183881

8. Palombi L, Pirillo MF, Marchei E, Jere H, Sagno JB, Luhanga R, et al. Concentrations of tenofovir, lamivudine and efavirenz in mothers and children enrolled under Option B-Plus approach in Malawi. J Antimicrob Chemother. 2016;71:1027–30. doi: 10.1093/jac/dkv435 26679247

9. Benaboud S, Pruvost A, Coffie PA, Ekouévi DK, Urien S, Arrivé E, et al. Concentrations of tenofovir and emtricitabine in breast milk of HIV-1-infected women in Abidjan, Cote d'Ivoire, in the ANRS 12109 TEmAA Study, Step 2. Antimicrob Agents Chemother. 2011 Mar;55(3):1315–7. doi: 10.1128/AAC.00514-10 21173182

10. Mirochnick M, Taha T, Kreitchmann R, Nielsen-Saines K, Kumwenda N, Joao E, et al; HPTN 057 Protocol Team. Pharmacokinetics and safety of tenofovir in HIV-infected women during labor and their infants during the first week of life. J Acquir Immune Defic Syndr. 2014 Jan 1;65(1):33–41. doi: 10.1097/QAI.0b013e3182a921eb 23979002

11. Noguchi LM, Montgomery ET, Biggio GR, Hendrix CW, Bogen DL, Hillier SL, et al. Topical tenofovir pharmacokinetics in breastfeeding mother-infant pairs. Antimicrob Agents Chemother. 2016 July 11. pii: AAC.00645-16. [Epub ahead of print].

12. Harrison A, Colvin CJ, Kuo C, Swartz A, Lurie M. Sustained high HIV incidence in young women in southern Africa: social, behavioral and structural factors and emerging intervention approaches. Curr HIV/AIDS Rpt. 2015;12:207–15.

13. UNAIDS. How AIDS changed everything; MDG 6: 15 years, 15 lessons of hope from the AIDS response. UNAIDS, Geneva, Switzerland, 2015. http://www.unaids.org/en/resources/documents/2015/MDG6_15years-15lessonsfromtheAIDSresponse.

14. United Nations Population Fund (UNFPA). Adolescent pregnancy: a review of the evidence. UNFPA, New York, NY. 2013. http://www.unfpa.org/sites/default/files/pub-pdf/ADOLESCENT%20PREGNANCY_UNFPA.pdf.

15. De Schacht C, Mabunda N, Ferreira OC, Ismael N, Calú N, Santos I, et al. High HIV incidence in the postpartum period sustains vertical transmission in settings with generalized epidemics: a cohort study in Southern Mozambique. J Int AIDS Soc. 2014;17:18808. doi: 10.7448/IAS.17.1.18808 24629842

16. Humphrey JH, Marinda E, Mutasa K, Moulton LH, Iliff PJ, Ntozini R, et al. Mother to child transmission of HIV among Zimbabwean women who seroconverted postnatally: prospective cohort study. BMJ. 2010;341:c6580. doi: 10.1136/bmj.c6580 21177735

17. Moodley D, Esterhuizen T, Reddy L, Moodley P, Singh B, Ngaleka L, et al. Incident HIV infection in pregnant and lactating women and its effect on mother-to-child transmission in South Africa. J Infect Dis. 2011;203:1231–4. doi: 10.1093/infdis/jir017 21398393

18. Wang L, Kourtis AP, Ellington S, Legardy-Williams J, Bulterys M. Safety of tenofovir during pregnancy for the mother and fetus: a systematic review. Clin Infect Dis. 2013 Dec;57(12):1773–81. doi: 10.1093/cid/cit601 24046310

19. Heffron R, Pintyre J, Matthews LT, Weber S, Mugo N. PrEP as peri-conception HIV prevention for women and men. Curr HIV/AIDS Rep. 2016;13:131–9. doi: 10.1007/s11904-016-0312-1 26993627

20. Zash R, Souda S, Chen JY, Binda K, Dryden-Peterson S, Lockman S, et al. Reassuring birth outcomes with tenofovir/emtricitabine/efavirenz used for prevention of mother-to-child transmission of HIV in Botswana. J Acquir Immune Defic Syndr. 2016;71:428–36. doi: 10.1097/QAI.0000000000000847 26379069

21. Chen JY, Ribaudo HJ, Souda S, Parekh N, Ogwu A, Lockman S, et al. Highly active antiretroviral therapy and adverse birth outcomes among HIV-infected women in Botswana. J Infect Dis. 2012;206:1695–705. doi: 10.1093/infdis/jis553 23066160

22. Zou H, Chen Y, Duan Z, Zhang H, Pan C. Virologic factors associated with failure of passive-active immunoprophylaxis in infants born to HBsAg-positive mothers. J Viral Hepat. 2012;19:e18–25. doi: 10.1111/j.1365-2893.2011.01492.x 22239517

23. Brown RS Jr, McMahon BJ, Lok AS, Wong JB, Ahmed AT, Mouchli MA, et al. Antiviral therapy in chronic hepatitis B viral infection during pregnancy: a systematic review and meta-analysis. Hepatology. 2016;63:319–33. doi: 10.1002/hep.28302 26565396

24. Pan CQ, Duan Z, Dai E, Zhang S, Han G, Wang Y, et al. Tenofovir to prevent hepatitis B transmission in mothers with high viral load. N Engl J Med. 2016;374:2324–34. doi: 10.1056/NEJMoa1508660 27305192

25. Mugo NR, Hong T, Celum C, Donnell D, Bukusi EA, John-Stewart G, et al. Partners PrEP Study Team. Pregnancy incidence and outcomes among women receiving preexposure prophylaxis for HIV prevention: a randomized clinical trial. JAMA. 2014;312:362–71. doi: 10.1001/jama.2014.8735 25038355

26. Bunge K, Balkus J, Noguchi L, Pan J, Piper J, Kabwigu S, et al. Pregnancy incidence and outcomes in women receiving tenofovir-based PrEP in the VOICE trial. International AIDS Conference. July 2015, Vancouver, Canada. Abs. MOPEC480.

27. Marrazzo JM, Ramjee G, Richardson B, Gomez K, Mgodi N, Nair G, et al. Tenofovir-based preexposure prophylaxis for HIV infection among African women. N Engl J Med. 2015;372:509–18. doi: 10.1056/NEJMoa1402269 25651245

28. Price JT, Wheeler SB, Stranix-Chibanda L, Hosek SG, Watts DH, Siberry GK, et al. Cost-effectiveness of pre-exposure prophylaxis during pregnancy and breastfeeding in sub-Saharan Africa. J Acquir Immune Defic Syndr. 2016;72 (Suppl 2);S145–53. doi: 10.1097/QAI.0000000000001063 27355502

29. Mujugira A, Celum C, Coombs RW, Campbell JD, Ndase P, Ronald A, et al; Partners PrEP Study Team. HIV Transmission Risk Persists During the First 6 Months of Antiretroviral Therapy. J Acquir Immune Defic Syndr. 2016 Aug 15;72(5):579–84. doi: 10.1097/QAI.0000000000001019 27070123

Interné lekárstvo

Článok vyšiel v časopise

PLOS Medicine

2016 Číslo 9
Najčítanejšie tento týždeň
Najčítanejšie v tomto čísle

Zvýšte si kvalifikáciu online z pohodlia domova

Získaná hemofilie - Povědomí o nemoci a její diagnostika
nový kurz

Eozinofilní granulomatóza s polyangiitidou
Autori: doc. MUDr. Martina Doubková, Ph.D.

Všetky kurzy
Zabudnuté heslo

Zadajte e-mailovú adresu, s ktorou ste vytvárali účet. Budú Vám na ňu zasielané informácie k nastaveniu nového hesla.


Nemáte účet?  Registrujte sa