Neurologic outcomes in HIV-exposed/uninfected infants exposed to antiretroviral drugs during pregnancy in Latin America and the Caribbean

Alicen B. Spaulding, Qilu Yu, Lucy Civitello, Marisa M. Mussi-Pinhata, Jorge Pinto, Ivete M. Gomes, Jorge O. Alarcón, George K. Siberry, D. Robert Harris, Rohan Hazra

Resultado de la investigación: Contribución a una revistaArtículorevisión exhaustiva

8 Citas (Scopus)

Resumen

To evaluate antiretroviral (ARV) drug exposure and other factors during pregnancy that may increase the risk of neurologic conditions (NCs) in HIV-exposed/uninfected (HEU) infants. A prospective cohort study was conducted at 24 clinical sites in Latin America and the Caribbean. Data on maternal demographics, health, HIV disease status, and ARV use during pregnancy were collected. Infant data included measurement of head circumference after birth and reported medical diagnoses at birth, 6-12 weeks, and 6 months. Only infants with maternal exposure to combination ARV therapy (cART) (≥3 drugs from ≥2 drug classes) during pregnancy were included. Microcephaly, defined as head circumference for age z-score less than -2, and NC were evaluated for their association with covariates, including individual ARVs, using bivariable and logistic regression analyses. From 2002 to 2009, 1,400 HEU infants met study inclusion criteria. At least one NC was reported in 134 (9.6%; 95% confidence interval [CI]: 8.1-11.2), microcephaly in 105 (7.5%; 95% CI: 6.2-9.0), and specific neurologic diagnoses in 33 (2.4%; 95% CI: 1.6-3.3) HEU infants. Microcephaly and NC were not significantly associated with any specific ARV analyzed (p > 0.05). Covariates associated with increased odds of NC included male sex (odds ratio [OR] = 1.9; 95% CI: 1.3-2.8), birth weight <2.5 kg (OR = 3.1; 95% CI: 2.1-4.8), 1-min Apgar score <7 (OR = 2.5; 95% CI: 1.4-4.4), and infant infections (OR = 2.5; 95% CI: 1.5-4.1). No ARV investigated was associated with adverse neurologic outcomes. Continued investigation of such associations may be warranted as new ARVs are used during pregnancy and cART exposure during the first trimester becomes increasingly common.

Idioma originalInglés
Páginas (desde-hasta)349-356
Número de páginas8
PublicaciónAIDS Research and Human Retroviruses
Volumen32
N.º4
DOI
EstadoPublicada - 1 abr 2016

Nota bibliográfica

Publisher Copyright:
© Mary Ann Liebert, Inc. 2016.

Huella

Profundice en los temas de investigación de 'Neurologic outcomes in HIV-exposed/uninfected infants exposed to antiretroviral drugs during pregnancy in Latin America and the Caribbean'. En conjunto forman una huella única.

Citar esto