logo
Science Portal
Copyright © Médecins Sans Frontières
v2.1.5153.produseast1
About MSF Science Portal
About
Contact Us
Frequently Asked Questions (FAQs)
Privacy Policy
Terms of Use
Copyright © Médecins Sans Frontières
v2.1.5153.produseast1
Journal Article
|Research

Adverse events associated with nevirapine use in pregnancy: a systematic review and meta-analysis

Ford NP, Calmy A, Andrieux-Meyer I, Hargreaves S, Mills EJ, Shubber Z
Download

Similar Content
Loading...
Loading...
Loading...
Adverse events associated with nevirapine use in pregnancy: a systematic review and meta-analysis | Journal Article / Research | MSF Science Portal
Abstract
INTRODUCTION
The risk of adverse drug events associated with nevirapine (NVP) is suggested to be greater in pregnant women. We conducted a systematic review and meta-analysis of severe adverse events in HIV-positive women who initiated NVP while pregnant.

METHODS
We searched six databases for studies reporting adverse events among HIV-positive pregnant women who had received NVP-based antiretroviral therapy for at least 7 days. Data were pooled by the fixed-effects method.

RESULTS
Twenty studies (3582 pregnant women) from 14 countries were included in the final review. The pooled proportion of patients experiencing a severe hepatotoxic event was 3.2% [95% confidence interval (CI) 2.1-4.3%], severe rash was experienced by 3.3% of patients (95% CI 2.1-4.5%) and 6.1% (95% CI 3.9-8.3%) of patients discontinued NVP due to an adverse event. These results were comparable to frequencies observed in the general adult patient population, and to frequencies reported in non-pregnant women within the same cohort. For pregnant women with a CD4 cell count above 250 cells/μl there was a non-significant tendency towards an increased likelihood of severe cutaneous adverse events (OR 1.4, 95% CI 0.8-2.4) and severe hepatotoxic events (OR 1.5, 95%CI 0.9-2.3) and consequently an increased risk of toxicity-driven regimen substitution (OR 1.7, 95% CI 1.1-2.6).

DISCUSSION
These results suggest that the frequency of adverse events associated with NVP use in pregnant women, although high, is no higher than reported for NVP in the general adult population. Pregnant women with a high CD4 cell count may be at increased risk of adverse events, but evidence supporting this association is weak.

Countries

Argentina Brazil Canada Côte d'Ivoire Ireland Italy Kenya Mozambique Netherlands South Africa Thailand United Kingdom United States of America

Subject Area

women's health

Languages

English
DOI
10.1097/QAD.0b013e32835e0752
Published Date
24 Apr 2013
PubMed ID
23299174
Journal
AIDS
Volume | Issue | Pages
Volume 27, Issue 7, Pages 1135-1143
Issue Date
2013-04-24
Dimensions Badge