HIV Insight: Maternal Tenofovir Disoproxil Fumarate Use in Pregnancy and Growth Outcomes among HIV-Exposed Uninfected Infants in Kenya

Background.

Tenofovir disoproxil fumarate (TDF) is commonly used in antiretroviral treatment (ART) and preexposure prophylaxis regimens. We evaluated the relationship of prenatal TDF use and growth outcomes among Kenyan HIV-exposed uninfected (HEU) infants. Materials and

Methods.

We included PCR-confirmed HEU infants enrolled in a cross-sectional survey of mother-infant pairs conducted between July and December 2013 in Kenya. Maternal ART regimen during pregnancy was determined by self-report and clinic records. Six-week and 9-month z-scores for weight-for-age (WAZ), weight-for-length (WLZ), length-for-age (LAZ), and head circumference-for-age (HCAZ) were compared among HEU infants with and without TDF exposure using t-tests and multivariate linear regression models.

Results.

Among 277 mothers who received ART during pregnancy, 63% initiated ART before pregnancy, of which 89 (32%) used TDF. No differences in birth weight (3.0 kg versus 3.1 kg, p = 0.21) or gestational age (38 weeks versus 38 weeks, p = 0.16) were detected between TDF-exposed and TDF-unexposed infants. At 6 weeks, unadjusted mean WAZ was lower among TDF-exposed infants (-0.8 versus -0.4, p = 0.03), with a trend towards association in adjusted analyses (p = 0.06). There were no associations between prenatal TDF use and WLZ, LAZ, and HCAZ in 6-week or 9-month infant cohorts.

Conclusion.

Maternal TDF use did not adversely affect infant growth compared to other regimens.

Full article at: http://goo.gl/WcUCw4

By: Pintye J¹, Langat A², Singa B³, Kinuthia J⁴, Odeny B⁵, Katana A², Nganga L², John-Stewart G⁶, McGrath CJ⁷.

¹Department of Global Health, University of Washington, Seattle, WA 98104, USA; Department of Nursing, University of Washington, Seattle, WA 98195, USA.

²United States Centers for Disease Control and Prevention (CDC), Nairobi 00202, Kenya.

³Center for Microbiology Research and Center for Clinical Research, Kenya Medical Research Institute, Nairobi 00202, Kenya.

⁴Department of Global Health, University of Washington, Seattle, WA 98104, USA; Department of Obstetrics & Gynecology, Kenyatta National Hospital, Nairobi 00202, Kenya.

⁵Department of Global Health, University of Washington, Seattle, WA 98104, USA.

⁶Department of Global Health, University of Washington, Seattle, WA 98104, USA; Department of Medicine, University of Washington, Seattle, WA 98195, USA; Department of Epidemiology, University of Washington, Seattle, WA 98195, USA.

⁷Department of Global Health, University of Washington, Seattle, WA 98104, USA; University of Texas Medical Branch, Galveston, TX 77555, USA

2015;2015:276851. doi: 10.1155/2015/276851. Epub 2015 Dec 28.

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