关于通过母乳喂养接触替诺福韦的指南：发育阶段药物剂量

StephenW

Int J Infect Dis. 2019 Jul 26. pii: S1201-9712(19)30308-X. doi: 10.1016/j.ijid.2019.07.023. [Epub ahead of print]
Guides Concerning Tenofovir Exposure via Breastfeeding: A Comparison of Drug Dosages by Developmental Stage.
Hu X1, Wang L2, Xu F3.
Author information
Abstract

Tenofovir disoproxil fumarate (TDF) is a prodrug of tenofovir, and after being administrated orally, it converts to tenofovir in the blood. With the increasing use of TDF in women for treatment and prevention of mother-to-child transmission (MTCT) of both human immunodeficiency virus (HIV) and hepatitis B virus (HBV), or the pre-exposure prophylaxis (PrEP) for HIV, many nursing mothers have to understand the risk of exposure to tenofovir via breastmilk and make the decision about breastfeeding while on TDF treatment. Despite the safety record of TDF in pregnancy, some guidelines recommend against its use during breastfeeding. In this paper, we compared the dosage levels of tenofovir exposure in fetuses, breastfed infants, and children receiving tenofovir treatment. We found that breastfed infants were exposed to only 0.5%-16% of the tenofovir dosage that fetuses experienced via placental transfer, and 0.01-0.04% of the recommended weight-adjusted therapeutic dose. The assessment of toxicity risk from the dose perspective is an important and natural way of addressing safety concerns about exposure to tenofovir via breastfeeding. Based on the safety data from fetuses and children with tenofovir exposure, and the comparatively negligible exposure dosage from breastfeeding, our study supports mothers on TDF treatment should be encouraged to breastfeed.

Copyright © 2019. Published by Elsevier Ltd.
KEYWORDS:

Antiviral therapy; Breastfeeding; Hepatitis B virus; Human Immunodeficiency virus; Tenofovir disoproxil fumarate

PMID:
    31357055
DOI:
    10.1016/j.ijid.2019.07.023

StephenW

Int J Infect Dis。 2019年7月26日.pii：S1201-9712（19）30308-X。 doi：10.1016 / j.ijid.2019.07.023。 [印刷前的电子版]
关于通过母乳喂养接触替诺福韦的指南：发育阶段药物剂量的比较。
胡X1，王二，徐F3。
作者信息
抽象

替诺福韦地索普西富马酸盐（TDF）是替诺福韦的前体药物，经口服给药后，可转化为血液中的替诺福韦。随着妇女越来越多地使用TDF治疗和预防人体免疫机能丧失病毒（HIV）和乙型肝炎病毒（HBV）的母婴传播（MTCT），或预防艾滋病毒的暴露前预防（PrEP），许多哺乳母亲必须了解通过母乳接触替诺福韦的风险，并在进行TDF治疗时做出母乳喂养的决定尽管TDF在怀孕期间有安全记录，但一些指南建议不要在母乳喂养期间使用。在本文中，我们比较胎儿，母乳喂养婴儿和接受替诺福韦治疗的儿童中替诺福韦暴露的剂量水平。我们发现母乳喂养的婴儿暴露于胎儿转移胎儿所经历的替诺福韦剂量的0.5％-16％，以及推荐的体重调整治疗剂量的0.01-0.04％。从pH角度评估毒性Icity风险是解决通过母乳喂养接触替诺福韦的安全性问题的重要且自然的方法。根据胎儿和替诺福韦暴露儿童的安全性数据，以及母乳喂养的相对可忽略不计的暴露剂量，我们的研究支持TDF治疗的母亲应该鼓励母乳喂养。

版权所有©2019。由Elsevier Ltd.出版
关键词：

抗病毒治疗;哺乳;乙型肝炎病毒;人类免疫缺陷病毒;替诺福韦地索普西富马酸盐

结论：
31357055
DOI：
10.1016 / j.ijid.2019.07.023

StephenW

https://www.ijidonline.com/article/S1201-9712(19)30308-X/pdf