Abstract | OBJECTIVE: DESIGN: A nested cohort study within a randomized clinical trial (the Mashi Study). Laboratory toxicities among infants born to women who initiated HAART before delivery were compared with toxicities among those born to women who received zidovudine and a single dose of nevirapine or placebo in labor. Infants were randomized to breastfeed with extended zidovudine or to formula-feed. METHODS: RESULTS: In-utero exposure to maternal HAART was associated with increased risk for neutropenia in infants up to 1 month of age; 21.7% of HAART-exposed infants were neutropenic, compared with 5.5% of the infants exposed to zidovudine (P < 0.01). However, neutropenia was no longer associated with antenatal exposure to HAART after 1 month of age. Postnatal exposure to HAART was not associated with hematologic or hepatic toxicities. Laboratory toxicities were clinically asymptomatic in all but one infant. CONCLUSION: Exposure to maternal HAART in utero may increase the risk for infant neutropenia, particularly among breastfed infants, but the clinical significance of this finding is uncertain. The lack of association between exposure to HAART through breastfeeding and long-term toxicities in infants is reassuring but deserves study in larger cohorts.
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Authors | Woong Hwan Bae, Carolyn Wester, Laura M Smeaton, Roger L Shapiro, Shahin Lockman, Kenneth Onyait, Ibou Thior, Max Essex |
Journal | AIDS (London, England)
(AIDS)
Vol. 22
Issue 13
Pg. 1633-40
(Aug 20 2008)
ISSN: 1473-5571 [Electronic] England |
PMID | 18670224
(Publication Type: Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural)
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Chemical References |
- Anti-HIV Agents
- Anti-Retroviral Agents
- Biomarkers
- Hemoglobins
- Zidovudine
- Nevirapine
- Aspartate Aminotransferases
- Alanine Transaminase
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Topics |
- Alanine Transaminase
(blood)
- Anti-HIV Agents
(adverse effects, therapeutic use)
- Anti-Retroviral Agents
(adverse effects, therapeutic use)
- Antiretroviral Therapy, Highly Active
(adverse effects)
- Aspartate Aminotransferases
(blood)
- Biomarkers
(blood)
- Botswana
- Breast Feeding
- Cohort Studies
- Female
- Follow-Up Studies
- HIV Infections
(drug therapy, immunology, transmission)
- HIV-1
- Hemoglobins
(analysis)
- Humans
- Infant
- Infant, Newborn
- Infectious Disease Transmission, Vertical
- Male
- Neutropenia
(etiology, immunology)
- Nevirapine
(adverse effects, therapeutic use)
- Platelet Count
- Pregnancy
- Pregnancy Complications, Infectious
(drug therapy, immunology)
- Prenatal Exposure Delayed Effects
- Zidovudine
(adverse effects, therapeutic use)
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