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Accepted (AM)Open Access (License Unspecified), Open
Journal article
Birth Defects Among Children Born to Human Immunodeficiency Virus-Infected Women Pediatric AIDS Clinical Trials Protocols 219 and 219C
The Pediatric infectious disease journal, v 29(8), pp 721-727
01 Aug 2010
PMID: 20539252
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background: Some studies have detected associations between in utero antiretroviral therapy (ARV) exposure and birth defects but evidence is inconclusive.
Methods: A total of 2202 human immunodeficiency virus (HIV)-exposed children enrolled in the Pediatric AIDS Clinical Trials Group 219 and 219 C protocols before 1 year of age were included. Birth defects were classified using the Metropolitan Atlanta Congenital Defects Program coding. Logistic regression models were used to evaluate associations between first trimester in utero ARV exposure and birth defects.
Results: A total of 117 live-born children had birth defects for a prevalence of 5.3% (95% confidence interval [CI] : 4.4, 6.3). Prevalence did not differ by HIV infection status or overall ARV exposure; rates were 4.8% (95% CI: 3.7, 6.1) and 5.8% (95% CI: 4.2, 7.8) in children without and with first trimester ARV exposure, respectively. The defect rate was higher among children with first trimester efavirenz exposure (5/32, 15.6%) versus children without first trimester efavirenz exposure (adjusted odds ratio [aOR] = 4.31 [95% CI: 1.56, 11.86]). Protective effects of first trimester zidovudine exposure on musculoskeletal defects were detected (aOR = 0.24 [95% CI: 0.08, 0.69]), while a higher risk of heart defects was found (aOR = 2.04 [95% CI: 1.03, 4.05]).
Conclusions: The prevalence of birth defects was higher in this cohort of HIV-exposed children than in other pediatric cohorts. There was no association with overall ARV exposure, but there were some associations with specific agents, including efavirenz. Additional studies are needed to rule out confounding and to evaluate newer ARV agents.
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Details
- Title
- Birth Defects Among Children Born to Human Immunodeficiency Virus-Infected Women Pediatric AIDS Clinical Trials Protocols 219 and 219C
- Creators
- Susan B. Brogly - Cancer Research And BiostatisticsMark J. Abzug - University of DenverD. Heather Watts - National Institutes of HealthColeen K. Cunningham - Duke University Medical CenterPaige L. Williams - Harvard University ,James Oleske - New Jersey Medical School (NJMS), Pediatrics, Division of Allergy/Immunology/Infectious and Pulmonary DiseasesDaniel Conway - Drexel UniversityRhoda S. Sperling - Icahn School of Medicine at Mount SinaiHans Spiegel - Montefiore Med Ctr, Adolescent AIDS Program, Bronx, NY 10467 USARussell B. Van Dyke - Tulane University
- Publication Details
- The Pediatric infectious disease journal, v 29(8), pp 721-727
- Publisher
- Lippincott Williams & Wilkins
- Number of pages
- 7
- Grant note
- U01 AI068632 / National Institute of Allergy and Infectious Diseases (NIAID); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Allergy & Infectious Diseases (NIAID) Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD) F32DK009001 / NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK) 5 U01 AI41110; 1 U01 AI068616 / Statistical and Data Analysis Center at Harvard School of Public Health, under the NIAID; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Allergy & Infectious Diseases (NIAID) AI068632 / National Institute of Mental Health (NIMH); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Mental Health (NIMH) N01-DK-9-001/HHSN267200800001C / NICHD; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD) UM1AI068632 / NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Allergy & Infectious Diseases (NIAID)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Pediatrics
- Web of Science ID
- WOS:000280314900009
- Scopus ID
- 2-s2.0-77955173051
- Other Identifier
- 991019168982504721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Immunology
- Infectious Diseases
- Pediatrics