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In Utero Efavirenz Exposure and Neurodevelopmental Outcomes in HIV-exposed Uninfected Children in Botswana
| Content Provider | Scilit |
|---|---|
| Author | Cassidy, Adam R. Williams, Paige L. Leidner, Jean Mayondi, Gloria Ajibola, Gbolahan Makhema, Joseph Holding, Penny A. Powis, Kathleen M. Batlang, Oganne Petlo, Chipo Shapiro, Roger Kammerer, Betsy Lockman, Shahin |
| Copyright Year | 2019 |
| Description | Journal: The Pediatric infectious disease journal Background: Minimal data exist related to neurodevelopment after in utero exposure to Efavirenz (EFV). We sought to compare neurodevelopmental outcomes in HIV-exposed/uninfected (HEU) children with in utero exposure to EFV-based triple antiretroviral treatment (ART) versus non-EFV-based ART, and to examine whether timing of initial EFV exposure is associated with neurodevelopment deficits. Methods: Women living with HIV who had received EFV-based ART during pregnancy and whose HEU newborn participated in a prior study were reconsented for their HEU toddler to undergo neurodevelopmental testing at 24 months old. We administered the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III), Developmental Milestones Checklist (DMC) and Profile of Social Emotional Development (PSED). We compared outcomes to previously-collected data from a cohort of 24-month-old HEU children with in utero exposure to non-EFV-based ART. Adjusted general linear models were used to compare mean outcomes. Results: Our analysis included 493 HEU children (126 EFV-exposed, 367 EFV-unexposed). Adjusted mean scores for the EFV-exposed group were worse than the EFV-unexposed group on BSID-III Receptive Language (adjusted means = 21.5 vs. 22.5, P = 0.05), DMC Locomotor (30.7 vs. 32.0, P < 0.01) and Fine Motor scales (17.8 vs. 19.2, P < 0.01); and PSED (11.7 vs. 9.9, P = 0.02); but better on the DMC Language scale (17.6 vs. 16.5, P = 0.01). Earlier (vs. later) EFV exposure was associated with worse scores on the BSID-III Receptive Language scale (20.7 vs. 22.2, P = 0.02). Conclusions: HEU children exposed in utero to EFV-based ART may be at higher risk for neurodevelopmental and social-emotional deficits than HEU children exposed to non-EFV-based ART. |
| Related Links | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6629483/pdf |
| Ending Page | 834 |
| Page Count | 7 |
| Starting Page | 828 |
| ISSN | 08913668 |
| e-ISSN | 15320987 |
| DOI | 10.1097/inf.0000000000002332 |
| Journal | The Pediatric infectious disease journal |
| Issue Number | 8 |
| Volume Number | 38 |
| Language | English |
| Publisher | Ovid Technologies (Wolters Kluwer Health) |
| Publisher Date | 2019-08-01 |
| Access Restriction | Open |
| Subject Keyword | Journal: The Pediatric infectious disease journal Womens Studies Child, Neurodevelopment, Hiv-exposed/uninfected, Efavirenz |
| Content Type | Text |
| Resource Type | Article |
| Subject | Infectious Diseases Pediatrics, Perinatology and Child Health Microbiology (medical) |
