First-trimester exposure to newer antiretroviral agents and congenital anomalies in a US cohort.
| Autor: | Fung K; Department of Epidemiology, Harvard T.H. Chan School of Public Health., Hernandez-Diaz S; Department of Epidemiology, Harvard T.H. Chan School of Public Health., Zash R; Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA., Chadwick EG; Department of Pediatrics (Infectious Diseases), Northwestern University Feinberg School of Medicine, Chicago, IL., Van Dyke RB; Department of Pediatrics, Tulane University School of Medicine, New Orleans, LA., Broadwell C; Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health., Jao J; Department of Pediatrics (Infectious Diseases), Northwestern University Feinberg School of Medicine, Chicago, IL., Powis K; Division of Internal Medicine and Pediatrics, Massachusetts General Hospital.; Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA., Yee LM; Department of Obstetrics and Gynecology (Maternal Fetal Medicine), Northwestern University Feinberg School of Medicine, Chicago, IL., Williams PL; Department of Epidemiology, Harvard T.H. Chan School of Public Health.; Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health.; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA. |
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| Jazyk: | angličtina |
| Zdroj: | AIDS (London, England) [AIDS] 2024 Sep 01; Vol. 38 (11), pp. 1686-1695. Date of Electronic Publication: 2024 Jun 11. |
| DOI: | 10.1097/QAD.0000000000003955 |
| Abstrakt: | Objective: To characterize associations of exposure to newer antiretroviral medications in the first trimester with congenital anomalies among infants born to persons with HIV in the United States. Design: Longitudinal cohort of infants born 2012-2022 to pregnant persons with HIV enrolled in the Surveillance Monitoring for ART Toxicities (SMARTT) study. Methods: First-trimester exposures to newer antiretrovirals (ARVs) were abstracted from maternal medical records. Trained site staff conducted physical exams and abstracted congenital anomalies from infant medical records. Investigators classified anomalies using the Metropolitan Atlanta Congenital Defects Program classification system. The prevalence of major congenital anomalies identified by age one year was estimated for infants exposed and unexposed to each ARV. Generalized estimating equation models were used to estimate the odds ratio (OR) of major congenital anomalies for each ARV exposure, adjusting for potential confounders. Results: Of 2034 infants, major congenital anomalies were identified in 135 [6.6%; 95% confidence interval (CI): 5.6-7.8%]. Cardiovascular ( n = 43) and musculoskeletal ( n = 37) anomalies were the most common. Adjusted ORs (95% CI) of congenital anomalies were 1.03 (0.62-1.72) for darunavir, 0.91 (0.46-1.81) for raltegravir, 1.04 (0.58-1.85) for rilpivirine, 1.31 (0.71-2.41) for elvitegravir, 0.76 (0.37-1.57) for dolutegravir, and 0.34 (0.05-2.51) for bictegravir, compared to those unexposed to each specific ARV. Findings were similar after adjustment for nucleoside/nucleotide backbones. Conclusions: The odds of congenital anomalies among infants with first-trimester exposure to newer ARVs did not differ substantially from those unexposed to these specific ARVs, which is reassuring. Continued evaluation of these ARVs with larger studies will be needed to confirm these findings. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.) |
| Databáze: | MEDLINE |
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