Maraviroc Pharmacokinetics in HIV-1-Infected Pregnant Women

Clin Infect Dis. 2015 Nov 15;61(10):1582-9. doi: 10.1093/cid/civ587. Epub 2015 Jul 22.


Objective: To describe the pharmacokinetics of maraviroc in human immunodeficiency virus (HIV)-infected women during pregnancy and post partum.

Methods: HIV-infected pregnant women receiving maraviroc as part of clinical care had intensive steady-state 12-hour pharmacokinetic profiles performed during the third trimester and ≥2 weeks after delivery. Cord blood samples and matching maternal blood samples were taken at delivery. The data were collected in 2 studies: P1026 (United States) and PANNA (Europe). Pharmacokinetic parameters were calculated.

Results: Eighteen women were included in the analysis. Most women (12; 67%) received 150 mg of maraviroc twice daily with a protease inhibitor, 2 (11%) received 300 mg twice daily without a protease inhibitor, and 4 (22%) had an alternative regimen. The geometric mean ratios for third-trimester versus postpartum maraviroc were 0.72 (90% confidence interval, .60-.88) for the area under the curve over a dosing interval (AUCtau) and 0.70 (0.58-0.85) for the maximum maraviroc concentration. Only 1 patient showed a trough concentration (Ctrough) below the suggested target of 50 ng/mL, both during pregnancy and post partum. The median ratio of maraviroc cord blood to maternal blood was 0.33 (range, 0.03-0.56). The viral load close to delivery was <50 copies/mL in 13 women (76%). All children were HIV negative at testing.

Conclusions: Overall maraviroc exposure during pregnancy was decreased, with a reduction in AUCtau and maximum concentration of about 30%. Ctrough was reduced by 15% but exceeded the minimum Ctrough target concentration. Therefore, the standard adult dose seems sufficient in pregnancy.

Clinical trials registration: NCT00825929 and NCT000422890.

Trial registration: NCT00422890 NCT00825929.

Keywords: HIV; MTCT; maraviroc; pharmacokinetics; pregnancy.

Publication types

  • Clinical Trial, Phase IV
  • Multicenter Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anti-HIV Agents / administration & dosage
  • Anti-HIV Agents / pharmacokinetics*
  • Blood Chemical Analysis
  • Cyclohexanes / administration & dosage
  • Cyclohexanes / pharmacokinetics*
  • Europe
  • Female
  • HIV Infections / drug therapy*
  • Humans
  • Maraviroc
  • Pregnancy
  • Pregnancy Complications, Infectious / drug therapy*
  • Triazoles / administration & dosage
  • Triazoles / pharmacokinetics*
  • United States
  • Young Adult


  • Anti-HIV Agents
  • Cyclohexanes
  • Triazoles
  • Maraviroc

Associated data