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29.10.2019 | Original Article

Safety of tenofovir during pregnancy: early growth outcomes and hematologic side effects in HIV-exposed uninfected infants

verfasst von: Vera Seidel, Katharina Weizsäcker, Wolfgang Henrich, Rebecca C. Rancourt, Christoph Bührer, Renate Krüger, Cornelia Feiterna-Sperling

Erschienen in: European Journal of Pediatrics

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Abstract

Intrauterine exposure to zidovudine-based combination antiretroviral therapy (cART) can cause severe anemia within the first weeks of life. Tenofovir disoproxil fumarate (TDF)–based regimens may have less hematologic side effects but may affect growth parameters. This study aimed to assess the safety of TDF for prevention of mother-to-child transmission (PMTCT) in HIV-exposed uninfected infants regarding early growth outcomes and hematologic side effects. Our retrospective observational cohort study included children born (n = 232) to HIV-infected mothers (n = 228) on cART. Blood counts were compared at birth, 4–6 weeks, and 3, 12 and 18 months of age. Growth parameters were measured at birth and 12 and 18 months of age. Data were analyzed according to treatment group (TDF and non-TDF cART regimes). The median hemoglobin (Hgb) was significantly lower in the non-TDF-based group at birth (15.4 g/dl vs. 16.9 g/dl; **p = 0.002) and at 4–6 weeks of age (9.9 g/dl vs. 10.4 g/dl; **p = 0.004). The mean corpuscular volume was higher in the non-TDF-based group (109 fl vs. 105 fl; ***p < 0.001) as well at 4–6 weeks (102 fl vs. 95 fl; ***p < 0.001). In the TDF-based group, a higher proportion of neutropenia (grade 2 and higher) compared to the non-TDF-group (21.4% vs. 11%; *p = 0.015) was observed at three months of age. This effect was transient. There was no difference in growth.

Conclusions: TDF appears to have no major side effects in our cohort. Transient anemia was observed more commonly with non-TDF regimens. However, our research suggests a potential delayed effect of TDF on neutrophils at 3 months of age.

What is Known: • TDF is suspected to affect the growth of HIV-exposed uninfected infants. • Non-TDF-based cART regimes for prevention of mother-to-child transmission of HIV often result in transient anemia in the infant.
What is New: • TDF appears to have no major side effects regarding the growth of HIV-exposed uninfected infants. • Our research suggests a potential delayed effect of TDF on neutrophils at 3 months of age in these infants.

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Titel: Safety of tenofovir during pregnancy: early growth outcomes and hematologic side effects in HIV-exposed uninfected infants
verfasst von: Vera Seidel
Katharina Weizsäcker
Wolfgang Henrich
Rebecca C. Rancourt
Christoph Bührer
Renate Krüger
Cornelia Feiterna-Sperling
Publikationsdatum: 29.10.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: European Journal of Pediatrics
Print ISSN: 0340-6199
Elektronische ISSN: 1432-1076
DOI: https://doi.org/10.1007/s00431-019-03481-x

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Safety of tenofovir during pregnancy: early growth outcomes and hematologic side effects in HIV-exposed uninfected infants

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Neuer Typ-1-Diabetes bei Kindern am Wochenende eher übersehen

Neue Studienergebnisse zur Myopiekontrolle mit Atropin

Spinale Muskelatrophie: Neugeborenen-Screening lohnt sich

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