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Assessment of Nevirapine Prophylactic and Therapeutic Dosing Regimens for Neonates

หน่วยงาน มหาวิทยาลัยเชียงใหม่

รายละเอียด

ชื่อเรื่อง : Assessment of Nevirapine Prophylactic and Therapeutic Dosing Regimens for Neonates
นักวิจัย : Cressey T. , Punyawudho B. , Le Coeur S. , Jourdain G. , Saenjum C. , Capparelli E. , Jittayanun K. , Phanomcheong S. , Luvira A. , Borkird T. , Puangsombat A. , Aarons L. , Sukrakanchana P. , Urien S. , Lallemant M. , Sangsawang S. , Achalapong J. , Preedisripipat K. , Putiyanun C. , Wanchaitanawong V. , Yuthavisuthi P. , Ngampiyaskul C. , Kanjanavikai P. , Chotivanich N. , Hongsiriwon S. , Suwankornsakul W. , Sreshthatat P. , Kanjanasing A. , Kwanchaipanich R. , Rawangban B. , Santadusit S. , Jarupanich T. , Warachit B. , Siriwachirachai T. , Rojanakarin P. , Vivatpatanakul K. , Hanpinitsak S. , Wanasiri P. , Srirojana S. , Kongpanichkul R. , Bunjongpak S. , Sabsanong P. , Liampongsabuddhi P. , Pongdetudom K. , Khamja P. , Akarathum N. , Phonin S. , Limpitikul W. , Jungpipun J. , Petprakorp R. , Mahattanan S. , Kotchawet S. , Pilalai T.
คำค้น : -
หน่วยงาน : มหาวิทยาลัยเชียงใหม่
ผู้ร่วมงาน : -
ปีพิมพ์ : 2560
อ้างอิง : 15254135 , 2-s2.0-85025687300 , 10.1097/QAI.0000000000001447 , https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85025687300&origin=inward , http://cmuir.cmu.ac.th/jspui/handle/6653943832/40175
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ความสัมพันธ์ : -
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บทคัดย่อ/คำอธิบาย :

© Copyright 2017 Wolters Kluwer Health, Inc. All rights reserved. Background: Nevirapine (NVP) is a key component of antiretroviral prophylaxis and treatment for neonates. We evaluated current World Health Organization (WHO) weight-band NVP prophylactic dosing recommendations and investigated optimal therapeutic NVP dosing for neonates. Methods: The PHPT-5 study in Thailand assessed the efficacy of "Perinatal Antiretroviral Intensification" to prevent mother-to-child transmission of HIV in women with < 8 weeks of antiretroviral treatment before delivery (NCT01511237). Infants received a 2-week course of zidovudine/lamivudine/NVP (NVP syrup/once daily: 2 mg/kg for 7 days; then 4 mg/kg for 7 days). Infant samples were assessed during the first 2 weeks of life. NVP population pharmacokinetics (PK) parameters were estimated using nonlinear mixed-effects models. Simulations were performed to estimate the probability of achieving target NVP trough concentrations for prophylaxis ( > 0.10 mg/L) and for therapeutic efficacy ( > 3.0 mg/L) using different infant dosing strategies. Results: Sixty infants (55% male) were included. At birth, median (range) weight was 2.9 (2.3-3.6) kg. NVP concentrations were best described by a 1-compartment PK model. Infant weight and postnatal age influenced NVP PK parameters. Based on simulations for a 3-kg infant, ≥92% would have an NVP trough > 0.1 mg/L after 48 hours through 2 weeks using the PHPT-5 and WHO-dosing regimens. For NVP-based therapy, a 6-mg/kg twice daily dose produced a trough > 3.0 mg/L in 87% of infants at 48 hours and 80% at 2 weeks. Conclusion: WHO weight-band prophylactic guidelines achieved target concentrations. Starting NVP 6 mg/kg twice daily from birth is expected to achieve therapeutic concentrations during the first 2 weeks of life.

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