Meet the CIPHER fellows

Adrie Bekker

Year awarded: 2017
Institution: Stellenbosch University, South Africa
Research site: Stellenbosch University, Family Clinical Research Unit, Tygerberg Hospital, Cape Town
Primary mentor: Mark Cotton, Stellenbosch University

Adrie Bekker is a neonatologist in the Department of Paediatrics and Child Health, Stellenbosch University. She recently completed a PhD focused on the prevention and treatment of perinatal and infant TB in the HIV era.

More information on Adrie | Email

“Outcomes for maternal-infant pairs can be improved by accurately dosing premature babies born to mothers living with HIV.”

Research project: Pharmacokinetic and safety characteristics of nevirapine and lopinavir in low birth weight infants exposed to and living with HIV

The issue

Despite limited pharmacokinetic (PK) and safety data available, nevirapine (NVP) and lopinavir/ritonavir (LPV/r) are widely used in low birth weight (<2,500 grams) infants exposed to and living with HIV. To better characterize ARV and antituberculosis medicines in low birth weight infants, the International Maternal Pediatric Adolescent AIDS Clinical Trials Group (IMPAACT) designed and implemented a phase IV prospective PK study in South Africa, conducted at the Family Clinical Research Unit and the Perinatal HIV Research Unit. Dr A Bekker serves as protocol vice-chair.

The CIPHER project

This CIPHER fellowship will enable her to obtain the necessary statistical skills and sophisticated pharmacological techniques to fully describe the PK and safety of NVP and LPV/r in low birth weight infants. Other objectives include:

  • To describe the association of PK parameters with birth weight, gestational age, postnatal age and other clinical variables
  • To describe the impact of CYP2B6 genetic variants on NVP metabolism
  • To develop population PK models of NVP and LPV/r
  • To use population PK models to perform Monte Carlo simulations of current and alternative dosing regimens for ARVs in this population.

The impact

Population pharmacokinetic analysis will provide an understanding of NVP and LPV/r exposures in young infants across the size and maturation spectrum. Increased knowledge of NVP and LPV/r PK and safety use should result in improved dosing guidelines in low birth weight infants.