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8th Annual Conference Of The British HIV Association [BHIVA]19 – 21 April 2002, University of York, York |
[AUTHOR(S):] CJ Foster1, I Roberts2, EGH Lyall1 and GP Taylor1,2
1 Family HIV Clinic, St Mary’s Hospital, and 2Imperial College, London
BHIVA Conf 2002 Apr 19-21;8:O15
AIM: To compare the effect of monotherapy versus combination antiretroviral therapy on neonatal haemoglobin (Hb) in non-HIV-infected infants.
METHODS: Retrospective review of infants born at St Mary's to HIV-infected women between October 1998 and September 2001.
PATIENTS: Of the 53 women identified, 74% were of black African origin and 25% were diagnosed on antenatal screening; 24 conceived on combination therapy, and 13 received third-trimester zidovudine (ZDV) alone. At delivery, the median maternal CD4 count was 360 cells/µL (23%), and 72% had an undetectable viral load. Of the 54 live infants, 31 received ZDV monotherapy, 21 other antiretroviral and 32 received septrin. All infants were HIV polymerase chain reaction (PCR)-negative.
RESULTS: Mean Hb at birth was 14.1 g/dl, which is more than 2 standard deviations below the age-adjusted mean of 18.5 g/dl. No significant difference in Hb was observed between those infants exposed to antiretroviral therapy from conception compared with those only exposed from second/third trimester, Student's t-test, P=0.54. However, a significant reduction in Hb was observed in those infants exposed in utero to antiretroviral therapy that included ZDV (mean 13.6 g/dl) compared with antiretroviral therapy without ZDV (mean 16.3 g/dl), Student's t-test, P=0.049. One infant required transfusion and four received iron/folic acid supplementation. Two infants did not receive postnatal antiretroviral therapy due to anaemia. The anaemia had resolved by 3 months of age.
CONCLUSIONS: Perinatal antiretroviral therapy is highly effective in preventing the vertical transmission of HIV-1 but causes significant reduction in neonatal Hb that, in this cohort, was independent of length of antiretroviral exposure but most marked with ZDVcontaining regimens.
PRESENTING AUTHOR: CJ Foster
020419
O15
Copyright © 2002 - British HIV Association (BHIVA) Reproduction of this abstract (other than one copy for personal reference) must be cleared through the BHIVA Organising Secretariat 1 Mountview Court, 310 Friern Barnet Lane, London N20 0LD