Surveillance monitoring for safety of in utero antiretroviral therapy exposures: current strategies and challenges
Identifieur interne : 000D77 ( Main/Exploration ); précédent : 000D76; suivant : 000D78Surveillance monitoring for safety of in utero antiretroviral therapy exposures: current strategies and challenges
Auteurs : Rebecca M. Zash [États-Unis] ; Paige L. Williams [États-Unis] ; Jeanne Sibiude ; Hermione Lyall [Royaume-Uni] ; Fatima Kakkar [Canada]Source :
- Expert opinion on drug safety [ 1474-0338 ] ; 2016.
Abstract
The use of antiretroviral therapy (ART) in pregnancy to prevent vertical HIV transmission has been one of the most successful public health programs in the last decade. As a result, an unprecedented number of women are taking ART at conception and during pregnancy. Given few randomized studies evaluating safety of different ART regimens in pregnancy, ongoing drug safety surveillance is critical.
This review aims to provide a rationale for ART drug safety surveillance, describe changing patterns of ART use and summarize current surveillance efforts in both low-resource and high-resource settings. Additionally, biostatistical approaches to and challenges in analysis of observational surveillance data are discussed.
The global landscape of ART use in pregnancy is rapidly increasing and evolving. Any increase in adverse effects of in-utero exposure to ART has the potential to reduce the impact of improvements in infant morbidity and mortality gained from decreased vertical HIV transmission. ART drug safety surveillance should therefore be a critical piece of programs to prevent mother to child transmission in both high- and low-resource settings. Current surveillance efforts could be strengthened with long-term follow-up of exposed children, pooling of data across cohorts and standardized approaches to analysis.
Url:
DOI: 10.1080/14740338.2016.1226281
PubMed: 27552003
PubMed Central: 5071158
Affiliations:
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Zash</name><affiliation wicri:level="2"><nlm:aff id="A1">Beth Israel Deaconess Medical Center, Boston, MA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Massachusetts</region></placeName><wicri:cityArea>Beth Israel Deaconess Medical Center, Boston</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="A2">Harvard T. H. Chan School of Public Health, Boston, MA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Massachusetts</region></placeName><wicri:cityArea>Harvard T. H. Chan School of Public Health, Boston</wicri:cityArea></affiliation><affiliation><nlm:aff id="A3">Botswana Harvard AIDS Institute Partnership, Gaborone</nlm:aff><wicri:noCountry code="subfield">Gaborone</wicri:noCountry></affiliation></author><author><name sortKey="Williams, Paige L" sort="Williams, Paige L" uniqKey="Williams P" first="Paige L." last="Williams">Paige L. 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As a result, an unprecedented number of women are taking ART at conception and during pregnancy. Given few randomized studies evaluating safety of different ART regimens in pregnancy, ongoing drug safety surveillance is critical.</p></sec><sec id="S2"><title>Areas Covered</title><p id="P2">This review aims to provide a rationale for ART drug safety surveillance, describe changing patterns of ART use and summarize current surveillance efforts in both low-resource and high-resource settings. Additionally, biostatistical approaches to and challenges in analysis of observational surveillance data are discussed.</p></sec><sec id="S3"><title>Expert Opinion</title><p id="P3">The global landscape of ART use in pregnancy is rapidly increasing and evolving. Any increase in adverse effects of in-utero exposure to ART has the potential to reduce the impact of improvements in infant morbidity and mortality gained from decreased vertical HIV transmission. ART drug safety surveillance should therefore be a critical piece of programs to prevent mother to child transmission in both high- and low-resource settings. Current surveillance efforts could be strengthened with long-term follow-up of exposed children, pooling of data across cohorts and standardized approaches to analysis.</p></sec></div></front></TEI><affiliations><list><country><li>Canada</li><li>Royaume-Uni</li><li>États-Unis</li></country><region><li>Angleterre</li><li>Grand Londres</li><li>Massachusetts</li></region><settlement><li>Londres</li></settlement></list><tree><noCountry><name sortKey="Sibiude, Jeanne" sort="Sibiude, Jeanne" uniqKey="Sibiude J" first="Jeanne" last="Sibiude">Jeanne Sibiude</name></noCountry><country name="États-Unis"><region name="Massachusetts"><name sortKey="Zash, Rebecca M" sort="Zash, Rebecca M" uniqKey="Zash R" first="Rebecca M." last="Zash">Rebecca M. Zash</name></region><name sortKey="Williams, Paige L" sort="Williams, Paige L" uniqKey="Williams P" first="Paige L." last="Williams">Paige L. Williams</name><name sortKey="Zash, Rebecca M" sort="Zash, Rebecca M" uniqKey="Zash R" first="Rebecca M." last="Zash">Rebecca M. Zash</name></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Lyall, Hermione" sort="Lyall, Hermione" uniqKey="Lyall H" first="Hermione" last="Lyall">Hermione Lyall</name></region></country><country name="Canada"><noRegion><name sortKey="Kakkar, Fatima" sort="Kakkar, Fatima" uniqKey="Kakkar F" first="Fatima" last="Kakkar">Fatima Kakkar</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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