Laboratory Abnormalities Among HIV-Exposed, Uninfected Infants: IMPAACT Protocol P1025
- PMID: 23687574
- PMCID: PMC3656554
- DOI: 10.1093/jpids/pis036
Laboratory Abnormalities Among HIV-Exposed, Uninfected Infants: IMPAACT Protocol P1025
Abstract
Background: Infant laboratory abnormalities have been associated with exposure to antiretrovirals and to trimethoprim/sulfamethoxazole (TMP/SMX).
Methods: We analyzed data from International Maternal Pediatric Adolescent AIDS Clinical Trials Group (IMPAACT) Protocol P1025, a prospective cohort study of human immunodeficiency virus type 1 (HIV)-infected women and their infants. Live-born, singleton, HIV-uninfected infants with at least 6 months of follow-up who represented the first pregnancy on study of HIV-infected mothers with at least 1 prenatal visit, CD4 count, and viral load during pregnancy and who used at least 1 antiretroviral during pregnancy were eligible for inclusion in this analysis.
Results: The study population comprised 1524 infants. During the first 6 months of life, 7.4% of laboratory serious adverse events (SAEs) were related to glucose, 7.2% were related to hemoglobin, 8.7% were related to absolute neutrophil count, and 4.0% were related to total lymphocyte count. The likelihood of laboratory SAEs decreased with increasing age for hemoglobin, absolute neutrophil count, and glucose. Infant preterm birth and current receipt of antiretroviral(s) were the factors with the strongest associations with laboratory SAEs.
Conclusions: The overall frequency of laboratory SAEs was low and decreased with age. Preterm infants are at higher risk of hemoglobin- and total lymphocyte count-related SAEs.
Published by Oxford University Press on behalf of the Pediatric Infectious Diseases Society 2012.
Figures
Similar articles
-
Birth Weight and Preterm Delivery Outcomes of Perinatally vs Nonperinatally Human Immunodeficiency Virus-Infected Pregnant Women in the United States: Results From the PHACS SMARTT Study and IMPAACT P1025 Protocol.Clin Infect Dis. 2017 Sep 15;65(6):982-989. doi: 10.1093/cid/cix488. Clin Infect Dis. 2017. PMID: 28575201 Free PMC article.
-
Infectious morbidity of breastfed, HIV-exposed uninfected infants under conditions of universal antiretroviral therapy in South Africa: a prospective cohort study.Lancet Child Adolesc Health. 2020 Mar;4(3):220-231. doi: 10.1016/S2352-4642(19)30375-X. Epub 2020 Jan 10. Lancet Child Adolesc Health. 2020. PMID: 31932246 Free PMC article.
-
Effect of co-trimoxazole prophylaxis on morbidity and mortality of HIV-exposed, HIV-uninfected infants in South Africa: a randomised controlled, non-inferiority trial.Lancet Glob Health. 2019 Dec;7(12):e1717-e1727. doi: 10.1016/S2214-109X(19)30422-X. Lancet Glob Health. 2019. PMID: 31708152 Clinical Trial.
-
Effect of pregnancy versus postpartum maternal isoniazid preventive therapy on infant growth in HIV-exposed uninfected infants: a post-hoc analysis of the TB APPRISE trial.EClinicalMedicine. 2023 Mar 17;58:101912. doi: 10.1016/j.eclinm.2023.101912. eCollection 2023 Apr. EClinicalMedicine. 2023. PMID: 36969345 Free PMC article.
-
Lack of long-term effects of in utero exposure to zidovudine among uninfected children born to HIV-infected women. Pediatric AIDS Clinical Trials Group Protocol 219/076 Teams.JAMA. 1999 Jan 13;281(2):151-7. doi: 10.1001/jama.281.2.151. JAMA. 1999. PMID: 9917118 Clinical Trial.
Cited by
-
Increased platelets count in HIV-1 uninfected infants born from HIV-1 infected mothers.Hematol Rep. 2019 Sep 27;11(3):7056. doi: 10.4081/hr.2019.7056. eCollection 2019 Sep 18. Hematol Rep. 2019. PMID: 31583065 Free PMC article.
-
Maternal Lopinavir/Ritonavir Is Associated with Fewer Adverse Events in Infants than Nelfinavir or Atazanavir.Infect Dis Obstet Gynecol. 2016;2016:9848041. doi: 10.1155/2016/9848041. Epub 2016 Apr 4. Infect Dis Obstet Gynecol. 2016. PMID: 27127401 Free PMC article.
-
Biomarkers from late pregnancy to 6 weeks postpartum in HIV-infected women who continue versus discontinue antiretroviral therapy after delivery.J Acquir Immune Defic Syndr. 2013 Aug 15;63(5):593-601. doi: 10.1097/QAI.0b013e31829b0b9f. J Acquir Immune Defic Syndr. 2013. PMID: 23714738 Free PMC article. Clinical Trial.
-
Trends in Neonatal Prophylaxis and Predictors of Combination Antiretroviral Prophylaxis in US Infants from 1990 to 2015.AIDS Patient Care STDS. 2018 Feb;32(2):48-57. doi: 10.1089/apc.2017.0295. AIDS Patient Care STDS. 2018. PMID: 30346801 Free PMC article.
-
Antiretroviral Therapy at Conception Leads to Lower Peripheral CD49a+ NK Cells and Higher SERPINB2.J Immunol Res. 2025 May 21;2025:4771787. doi: 10.1155/jimr/4771787. eCollection 2025. J Immunol Res. 2025. PMID: 40438469 Free PMC article.
References
-
- Panel on Treatment of HIV-Infected Pregnant Women and Prevention of Perinatal Transmission. Recommendations for use of antiretroviral drugs in pregnant HIV-1–infected women for maternal health and interventions to reduce perinatal HIV transmission in the United States. Available at: http://aidsinfo.nih.gov/ContentFiles/PerinatalGL.pdf . Accessed November 7, 2011. - PubMed
-
- Mofenson LM, Brady MT, Danner SP, et al. Guidelines for the prevention and treatment of opportunistic infections among HIV-exposed and HIV-infected children: recommendations from CDC, the National Institutes of Health, the HIV Medicine Association of the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, and the American Academy of Pediatrics. MMWR Recomm Rep. 2009;58:1–166. - PMC - PubMed
-
- Antiretroviral Pregnancy Registry Steering Committee. Antiretroviral Pregnancy Registry international interim report for 1 January 1989 through 31 January 2011. Available at: http://www.apregistry.com/forms/interim_report.pdf . Accessed November 7, 2011.
-
- Patel D, Thorne C, Fiore S, et al. Does highly active antiretroviral therapy increase the risk of congenital abnormalities in HIV-infected women? J Acquir Immune Defic Syndr. 2005;40:116–8. - PubMed
-
- Watts DH, Li D, Handelsman E, et al. Assessment of birth defects according to maternal therapy among infants in the Women and Infants Transmission Study. J Acquir Immune Defic Syndr. 2007;44:299–305. - PubMed
Grants and funding
LinkOut - more resources
Full Text Sources
Research Materials