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23-11-2011 | Bone health | Article

In utero antiretroviral therapy does not affect infant bone health

Abstract

Free abstract

MedWire News: Exposing infants to antiretroviral (ARV) agents in utero does not adversely affect their bone status, research shows.

Changes in bone measurements assessed by quantitative ultrasonography (QUS) in infants exposed to ARV therapy during pregnancy were similar to the changes observed in unexposed children, report investigators.

The use of combined potent ARV agents during pregnancy are effective for the prevention of HIV mother-to-child transmission and can now be considered "safe" for bone development, conclude Stefano Mora (San Raffaele Scientific Institute, Milan, Italy) and colleagues in the journal Bone.

The long-term use of combined ARV agents in children is associated with an increased risk for impaired bone mass and bone metabolism, as well as low bone mineral density (BMD) in adult patients.

However, administration of ARV to an HIV-positive mother during pregnancy, and to the baby after birth, as well as the avoidance of breast feeding, has reduced the rate of mother-to-child HIV transmission to about 1%.

To assess the risk from in utero exposure to ARV agents in 38 infants born to HIV-positive mothers, the researchers measured the speed-of-sound (SOS) at the tibia by QUS.

Assessed as soon as possible after birth, the median SOS measurement of ARV-exposed neonates was 3006 m/s and 3007 m/s in neonate controls not exposed to ARV therapy, a nonsignificant difference.

SOS measurements at 4 and 12 months of age in 17 ARV-exposed and 57 control infants showed that the SOS changed significantly over time in both groups, but did not significantly differ between the two groups.

The QUS bone measurements in the ARV-exposed infants decreased slightly at 4 months, but then increased significantly at 12 months.

"The QUS measurement increment during the first year of life was comparable to that observed in infants born from HIV-negative mothers, suggesting that ARV exposure does not have long-term effects on skeletal development," conclude Mora and colleagues.

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