Exposición a antirretrovirales y crecimiento en una cohorte de niños no infectados, hijos de madre con VIH positivo

Ibieta, M Fernández; Cano, J.M. Bellón; González-Tomé, María Isabel; Martín, Sara Guillén; Gómez, M. Navarro; José, María Isabel de; Beceiro, José; Iglesias, E.; Prieto, Luís; Santos, Maria José Albuquerque; Guardia, N. Martínez; Roa, M.A.; Regidor, J.

doi:10.1016/j.anpedi.2009.06.019

Cited by 8 publications

(4 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…39 Studies also demonstrate that the anthropometric effects of HIV are apparent even in utero where infants prenatally exposed to HIV but who were uninfected have lower birth lengths and weights compared with unexposed infants. 40,41 …”

Section: Discussionmentioning

confidence: 99%

Body Mass Index and Waist Circumference of HIV‐Infected Youth in a Miami Cohort

Arbeitman

O’Brien²,

Somarriba³

et al. 2014

J. pediatr. gastroenterol. nutr.

View full text Add to dashboard Cite

Objective Human immunodeficiency virus (HIV) infected youth are healthier due to effective antiretroviral therapies (ARVs). We compared anthropometric measurements and prevalence of overweight and obesity between perinatally-HIV-infected youth, a local HIV-uninfected comparison group and 2007–2010 National Health and Nutrition Examination Survey (NHANES) data. In addition, we compared only African American HIV-infected to NHANES African American. Methods Height, weight, body mass index (BMI) and waist circumference (WC) of HIV-infected youth, age 10–19 years, were compared among groups. BMI percentiles were categorized as underweight (≤5%), normal (5–<85%), overweight (85–<95%), and obese (≥95%). Clinical correlates were modeled as predictors of BMI and WC. Results 134 HIV-infected (including 103 African Americans) (mean age 16.5y), 75 HIV-uninfected (mean age 14.2y), and 3216 NHANES (including 771 NHANES African Americans) (mean age 15.0y) youth were included in the analysis. Height and weight z-scores of HIV-infected were lower than HIV-uninfected and NHANES (P≤0.056). BMI, WC, and BMI category were not statistically different between groups. In the HIV-infected African American group, BMI z-score was lower (0.49 vs 0.76; P=0.04) compared to NHANES African American. There were no significant predictors of BMI or WC for the HIV-infected group. Conclusion HIV-infected children have similar BMIs and WCs as uninfected children both locally and nationally and show similar high rates of obesity and overweight. However, when compared to a more racially similar African American national sample, HIV-infected children have a lower BMI, suggesting that there may be persistent anthropometric differences in HIV.

show abstract

Section: Discussionmentioning

confidence: 99%

Body Mass Index and Waist Circumference of HIV‐Infected Youth in a Miami Cohort

Arbeitman

O’Brien²,

Somarriba³

et al. 2014

J. pediatr. gastroenterol. nutr.

View full text Add to dashboard Cite

show abstract

“…A Thai study found no differences in weight-for-age, weight-for-length, or length-for-age z scores between infants exposed to <7.5 versus ≥7.5 weeks of AZT [85]. A Spanish cohort reported similar findings when evaluating HIV/ARV-exposed versus HIV-unexposed infants and HIV- versus HIV/ARV-exposed infants [86]. A multi-national study had comparable results when examining ART versus AZT monotherapy exposure [75].…”

Section: Discussionmentioning

confidence: 99%

Disclosing in utero HIV/ARV exposure to the HIV‐exposed uninfected adolescent: is it necessary?

Jao

Hazra

Mellins

et al. 2016

Journal of the International AIDS Society

View full text Add to dashboard Cite

IntroductionThe tremendous success of antiretroviral therapy has resulted in a diminishing population of perinatally HIV-infected children on the one hand and a mounting number of HIV-exposed uninfected (HEU) children on the other. As the oldest of these HEU children are reaching adolescence, questions have emerged surrounding the implications of HEU status disclosure to these adolescents. This article outlines the arguments for and against disclosure of a child's HEU status.DiscussionDisclosure of a child's HEU status, by definition, requires disclosure of maternal HIV status. It is necessary to weigh the benefits and harms which could occur with disclosure in each of the following domains: psychosocial impact, long-term physical health of the HEU individual and the public health impact. Does disclosure improve or worsen the psychological health of the HEU individual and extended family unit? Do present data on the long-term safety of in utero HIV/ARV exposure reveal potential health risks which merit disclosure to the HEU adolescent? What research and public health programmes or systems need to be in place to afford monitoring of HEU individuals and which, if any, of these require disclosure?ConclusionsAt present, it is not clear that there is sufficient evidence on whether long-term adverse effects are associated with in utero HIV/ARV exposures, making it difficult to mandate universal disclosure. However, as more countries adopt electronic medical record systems, the HEU status of an individual should be an important piece of the health record which follows the infant not only through childhood and adolescence but also adulthood. Clinicians and researchers should continue to approach the dialogue around mother–child disclosure with sensitivity and a cogent consideration of the evolving risks and benefits as new information becomes available while also working to maintain documentation of an individual's perinatal HIV/ARV exposures as a vital part of his/her medical records. As more long-term adult safety data on in utero HIV/ARV exposures become available these decisions may become clearer, but at this time, they remain complex and multi-faceted.

show abstract

“…(38) A study in Spain found no evidence for abnormal WAZ, LAZ, or HCAZ when comparing infants exposed to any vs. no in utero ARVs and those exposed to PI vs. non-PI based cART. (39) A small U.S. study comparing growth to 2 years in HEU and HIV-unexposed children found no differences in growth. (40) A combined analysis of ACTG 5190/IMPAACT 1054 participants did not find evidence of decreased WAZ, LAZ, or HCAZ in infants exposed to cART vs.…”

Section: Postnatal Growthmentioning

confidence: 98%

Metabolic Complications of in utero Maternal HIV and Antiretroviral Exposure in HIV-exposed Infants

Jao

Abrams

2014

Pediatric Infectious Disease Journal

View full text Add to dashboard Cite

Background Despite a wide body of literature supporting the use of antenatal antiretrovirals (ARV) for the prevention of mother to child transmission, there remains a need for continued monitoring as the intrauterine interval is a critical period during which fetal programming influences the future health and development of the child. Methods We conducted a systematic review of the current literature addressing potential metabolic complications of in utero HIV and ARV exposure. We describe studies evaluating metabolic outcomes such as intrauterine and early postnatal growth, bone health, and mitochondrial toxicity. Results Overall, infants exposed to HIV/ARV do not appear to exhibit vastly compromised intrauterine or early postnatal growth. However, some studies on the effect of combination antiretroviral therapy (cART) on small for gestational age (SGA) and low birth weight (LBW) outcomes in low-middle income countries show a risk for SGA/LBW while those in the U.S. do not. Postnatal growth to 1 year does not appear to be affected by intrauterine tenofovir exposure in African studies, but a U.S. study found statistically significant differences in length for age z scores (LAZ) at 1 year. Little data exists on long term bone health. Mitochondrial toxicity including abnormal mitochondrial morphology and DNA content, as well as neurologic deficits and death have been demonstrated in HIV/ARV–exposed infants. Conclusion Though gross measures of metabolic well-being appear to be reassuring, careful vigilance of even small risks for potential serious adverse effects to infants exposed to intrauterine HIV/ARVs is warranted as intrauterine fetal metabolic programming may substantially impact the future health of the child.

show abstract

Exposición a antirretrovirales y crecimiento en una cohorte de niños no infectados, hijos de madre con VIH positivo

Cited by 8 publications

References 20 publications

Body Mass Index and Waist Circumference of HIV‐Infected Youth in a Miami Cohort

Body Mass Index and Waist Circumference of HIV‐Infected Youth in a Miami Cohort

Disclosing in utero HIV/ARV exposure to the HIV‐exposed uninfected adolescent: is it necessary?

Metabolic Complications of in utero Maternal HIV and Antiretroviral Exposure in HIV-exposed Infants

Contact Info

Product

Resources

About