Related Experiment Video
Updated: Apr 11, 2026
A High-throughput Cre-Lox Activated Viral Membrane Fusion Assay to Identify Inhibitors of HIV-1 Viral Membrane Fusion
Published on: August 14, 2018
Cancer Among Children With Perinatal Exposure to HIV and Antiretroviral Medications--New Jersey, 1995-2010
Wade Ivy1, Steve R Nesheim, Sindy M Paul
1*Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA; †New Jersey Department of Health, Division of HIV/AIDS Services, Trenton, NJ; ‡New Jersey Department of Health, Communicable Disease Service, Trenton, NJ; and §New Jersey Department of Health, Cancer Epidemiology Services, Trenton, NJ.
Insights
Perinatal antiretroviral (ARV) exposure in infants born to HIV-infected mothers does not increase cancer risk. This study found no significant difference in cancer incidence among ARV-exposed infants compared to unexposed infants.
Area of Science:
- Pediatric Oncology
- Infectious Diseases
- Public Health
Background:
- Concerns exist regarding the potential cancer risk in infants exposed to antiretroviral (ARV) drugs during pregnancy or birth.
- Previous short-term studies have not identified an increased cancer risk associated with this exposure.
Purpose of the Study:
- To investigate the long-term cancer risk in children perinatally exposed to antiretroviral (ARV) drugs.
- To evaluate whether ARV prophylaxis for preventing mother-to-child HIV transmission impacts childhood cancer rates.
Main Methods:
- Retrospective cohort study utilizing New Jersey's Enhanced HIV/AIDS Reporting System and State Cancer Registry data (1995-2008).
- Identified HIV-exposed infants and tracked cancer diagnoses, comparing incidence rates to state and national averages.
- Calculated age- and sex-standardized incidence ratios (SIR) and 95% confidence intervals (CIs).
Main Results:
- Among 3,087 HIV-exposed children followed for a median of 9.8 years, 4 cancer cases were diagnosed.
- Cancer incidence was similar between ARV-exposed (14.3/100,000 person-years) and unexposed (22.5/100,000 person-years) infants.
- Observed cancer cases did not significantly differ from expected rates based on state (SIR=1.21) and national (SIR=1.27) references.
Conclusions:
- Current use of ARV for perinatal HIV prophylaxis appears safe regarding childhood cancer risk.
- Findings support existing 2014 federal guidelines recommending ARV prophylaxis for HIV-exposed infants.
Background:
Concerns remain regarding the cancer risk associated with perinatal antiretroviral (ARV) exposure among infants. No excessive cancer risk has been found in short-term studies.
Methods:
Children born to HIV-infected women (HIV-exposed) in New Jersey from 1995 to 2008 were identified through the Enhanced HIV/AIDS Reporting System and cross-referenced with data from the New Jersey State Cancer Registry to identify new cases of cancer among children who were perinatally exposed to ARV. Matching of individuals in the Enhanced HIV/AIDS Reporting System to the New Jersey State Cancer Registry was conducted based on name, birth date, Social Security number, residential address, and sex using AutoMatch. Age- and sex-standardized incidence ratio (SIR) and exact 95% confidence intervals (CIs) were calculated using New Jersey (1979-2005) and US (1999-2009) cancer rates.
Results:
Among 3087 children (29,099 person-years; median follow-up: 9.8 years), 4 were diagnosed with cancer. Cancer incidence among HIV-exposed children who were not exposed to ARV prophylaxis (22.5 per 100,000 person-years) did not differ significantly from the incidence among children who were exposed to any perinatal ARV prophylaxis (14.3 per 100,000 person-years). Furthermore, the number of cases observed among individuals exposed to ARV did not differ significantly from cases expected based on state (SIR = 1.21; 95% CI: 0.25 to 3.54) and national (SIR = 1.27; 95% CI: 0.26 to 3.70) reference rates.
Conclusions:
Our findings are reassuring that current use of ARV for perinatal HIV prophylaxis does not increase cancer risk. We found no evidence to alter the current federal guidelines of 2014 that recommend ARV prophylaxis of HIV-exposed infants.
