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In-utero triple antiretroviral exposure associated with decreased growth among HIV-exposed uninfected infants in Botswana
| Content Provider | Scilit |
|---|---|
| Author | Powis, Kathleen M. Smeaton, Laura Hughes, Michael D. Tumbare, Esther A. Souda, Sajini Jao, Jennifer Wirth, Kathleen Makhema, Joseph Lockman, Shahin Fawzi, Wafaie Shapiro, Roger L. |
| Copyright Year | 2016 |
| Description | Journal: Aids Objective: To assess associations between in-utero triple antiretrovirals (cART) versus zidovudine (ZDV) monotherapy exposure and growth among HIV-uninfected children of HIV-infected women in Botswana. Design: Secondary retrospective data analysis from two randomized intervention trials of mother-to-child HIV transmission prevention. Methods: The Mashi and Mma Bana studies enrolled HIV-infected pregnant women, following their children through 24 months of age. This analysis includes singleton, full-term, HIV-exposed uninfected children. Mothers received cART or ZDV at least 2 weeks predelivery, and breastfed up to 6 months. Weight-for-age (WAZ), length-for-age (LAZ) and weight-for-length (WLZ) z-scores were derived. Mean z-scores were compared by exposure group at 24 months (t-test, linear regression). Results: Of 819 children, 303 were ZDV- and 516 cART-exposed in utero. Maternal median enrolment CD4+ was higher among ZDV versus cART-treated mothers (393 versus 324 cells/μl; P < 0.0001). Median duration of antepartum antiretroviral use was shorter among ZDV-treated women (5.7 versus 12.0 weeks; P < 0.0001). Median months breastfed were similar (5.9 and 6.0; P = 0.43). At 24 months, mean LAZ and WAZ were significantly lower among cART-exposed children (LAZ –1.01 versus –0.74; P = 0.003) (WAZ –0.53 versus –0.30; P = 0.002) in unadjusted analyses. Adjusting for maternal CD4+, viral load, enrolment site and maternal anthropometric measures, cART-exposed children had significantly lower LAZ and WAZ at 24 months (P = 0.0004 for both). Conclusion: At 24 months, in-utero cART-exposed children had significantly lower LAZ and WAZ. Poor growth impacts childhood and adult mortality. These findings raise concerns for potential lasting health impacts among HIV-exposed uninfected children with in-utero cART exposure. |
| Related Links | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4685731/pdf |
| Ending Page | 220 |
| Page Count | 10 |
| Starting Page | 211 |
| ISSN | 02699370 |
| e-ISSN | 14735571 |
| DOI | 10.1097/qad.0000000000000895 |
| Journal | Aids |
| Issue Number | 2 |
| Volume Number | 30 |
| Language | English |
| Publisher | Ovid Technologies (Wolters Kluwer Health) |
| Publisher Date | 2016-01-01 |
| Access Restriction | Open |
| Subject Keyword | Journal: Aids Ethnic Studies Hiv-exposed Uninfected Infants In-utero Triple Antiretrovirals |
| Content Type | Text |
| Resource Type | Article |
| Subject | Infectious Diseases Immunology and Allergy Immunology |
