Levels of bone markers in a population of infants exposed in utero and during breastfeeding to tenofovir within an Option B+ programme in Malawi

Autor: Sandro Mancinelli, Marina Giuliano, Maria Cristina Marazzi, Giuseppe Liotta, Haswell Jere, Stefano Vella, Ersilia Buonomo, Marco Floridia, Roberta Amici, Mauro Andreotti, Clementina Maria Galluzzo, Jean-Baptiste Sagno, Leonardo Palombi, Paola Scarcella
Rok vydání: 2016
Předmět:
0301 basic medicine
Cyclopropanes
Male
Malawi
Infectious Disease Transmission
Settore MED/42 - Igiene Generale e Applicata
Physiology
HIV Infections
Bone remodeling
chemistry.chemical_compound
immune system diseases
Pregnancy
Medicine
Vertical
Pharmacology (medical)
education.field_of_study
Obstetrics
virus diseases
Lamivudine
Infectious Diseases
Breast Feeding
Alkynes
Female
medicine.drug
Microbiology (medical)
Adult
medicine.medical_specialty
Efavirenz
Settore MED/17 - Malattie Infettive
Anti-HIV Agents
Population
Alkaline Phosphatase
Benzoxazines
Biomarkers
Bone Resorption
Collagen Type I
Humans
Infant
Infant
Newborn
Infectious Disease Transmission
Vertical
Peptides
Tenofovir
Young Adult
Bone resorption
03 medical and health sciences
N-terminal telopeptide
education
Pharmacology
business.industry
medicine.disease
Newborn
030112 virology
chemistry
business
Breast feeding
Zdroj: The Journal of antimicrobial chemotherapy. 71(11)
ISSN: 1460-2091
Popis: Objectives No data are available on bone metabolism in infants exposed to tenofovir during breastfeeding. We investigated bone metabolism markers in the first year of life in infants from mothers who received tenofovir, lamivudine and efavirenz during pregnancy and 12 months of breastfeeding in a national Option B+ programme in Malawi. Methods Serum samples collected at 6 and 12 months in tenofovir-exposed infants and in a small sample of tenofovir-unexposed infants from the same clinical centre were analysed in batches for levels of bone-specific alkaline phosphatase (BAP; marker of bone formation) and of C-terminal telopeptide of type I collagen (CTX; marker of bone resorption). Results Overall, 136 tenofovir-exposed infants were evaluated. No infant had at either timepoint CTX values above the upper normal limit, while most of them had at 6 and 12 months levels of BAP above the upper normal limit for the age range. Levels of bone markers showed no differences by gender and no association with growth parameters. Tenofovir-unexposed and -exposed children had similar mean levels of bone markers at 6 months (CTX: 0.62 versus 0.55 ng/mL, P = 0.122; BAP: 384 versus 362 U/L, P = 0.631). Conclusions No significant association between treatment with tenofovir and CTX or BAP levels was found. The high levels of BAP, coupled to the normal levels observed for CTX, might reflect primarily skeletal growth. Potential negative effects of prolonged exposure to tenofovir through breastfeeding cannot however be excluded and longitudinal studies that evaluate bone mineralization status in children enrolled in Option B+ programmes are warranted.
Databáze: OpenAIRE
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