January 07, 2014
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Intrauterine, postnatal growth unaffected by exposure to HIV, antenatal antiretrovirals

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Exposure to HIV and antenatal antiretrovirals did not significantly affect infants’ intrauterine or early postnatal growth, according to study results published in The Pediatric Infectious Disease Journal.

Researchers reviewed current English, French and Spanish literature that addressed potential complications of HIV and antenatal antiretrovirals exposure in utero.

Overall, researchers found that the infants exposed to HIV and antenatal antiretrovirals were not significantly affected in terms of intrauterine or early postnatal growth. Results from some studies found that the use of combination antiretroviral therapy in low- to middle-income countries increased infants risk for low birth weight and other developmental complications. Studies conducted in the United States did not show these results.

African study findings showed that intrauterine tenofovir (Viread, Gilead Sciences) does not affect postnatal growth up to 1 year; however, results from an American study found significant differences in infants’ length for their age at 1 year. The review found minimal data about long-term bone health. Researchers found mitochondrial toxicity, neurologic deficits and death were significant outcomes of exposure to HIV and antenatal antiretrovirals.

“Though gross measures of metabolic well-being such as intrauterine and early postnatal growth appear to be reassuring, more complex appraisals of metabolic health will require more sophisticated measures of bone health, mitochondrial function, and even pathways of intermediary metabolism. Careful vigilance of even small risks for potential serious adverse effects to infants exposed to in utero HIV/[antenatal antiretrovirals] is warranted as intrauterine fetal metabolic programming poses a substantial impact on the future health of the child,” Jennifer Jao, MD, MPH, of the Icahn School of Medicine at Mount Sinai, and colleagues concluded.

Disclosure: Jao received salary support from the National Institute of Child Health and Human Development. The researchers report no relevant financial disclosures.