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Pediatric Neurodevelopmental Functioning After In Utero Exposure to Triple-NRTI vs. Dual-NRTI + PI ART in a

Deborah Kacanek1, Paige L Williams1, Gloria Mayondi2

  • 1Department of Biostatistics, Center for Biostatistics in AIDS Research, Harvard T. H. Chan School of Public Health, Boston, MA.

Journal of Acquired Immune Deficiency Syndromes (1999)
|July 18, 2018
PubMed

Insights

HIV-exposed uninfected children showed similar neurodevelopmental outcomes regardless of maternal antiretroviral treatment (ART) regimen. This suggests no short-term toxicity from nucleoside reverse transcriptase inhibitor (NRTI)-based ART in pregnant women.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Neuroscience

Background:

  • Antiretroviral treatment (ART) regimens containing nucleoside reverse transcriptase inhibitors (NRTIs) are used in HIV-infected pregnant women.
  • Potential neurodevelopmental effects of in utero ART exposure in HIV-exposed uninfected (HEU) children require investigation.

Purpose of the Study:

  • To compare neurodevelopmental outcomes in HEU children exposed to different ART regimens in utero.
  • To assess potential short-term neurotoxicity associated with NRTI-containing ART regimens.

Main Methods:

  • The Mma Bana randomized trial compared a triple-NRTI regimen with a dual-NRTI + protease inhibitor (PI) regimen in HIV-infected pregnant women.
  • Neurodevelopmental assessments were conducted at 24 months of age in HEU children using standardized tools.
  • Statistical analyses evaluated differences in neurodevelopmental scores between the two ART exposure groups.

Main Results:

  • A total of 197 HEU children (101 triple-NRTI, 96 dual-NRTI + PI) completed neurodevelopmental assessments.
  • Mean neurodevelopmental scores were similar across both ART exposure groups.
  • No significant differences were observed in any neurodevelopmental outcomes between the groups in unadjusted or adjusted models.

Conclusions:

  • In utero exposure to dual-NRTI + PI-based or triple-NRTI-based ART regimens did not result in significant differences in neurodevelopmental outcomes at 24 months in HEU children.
  • Findings suggest a lack of short-term neurodevelopmental toxicity associated with these ART regimens.
  • Long-term toxicity monitoring and evaluation of newer ART regimens are recommended.
Abstract

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