Life-threatening maternal and fetal macrocytic anemia from antiretroviral therapy.
BACKGROUND
Antiretroviral therapy is recommended for human immunodeficiency virus (HIV)-infected patients during pregnancy to reduce the vertical transmission to the newborn. Complications from this therapy are uncommon.


METHODS
A 38-year-old HIV-positive pregnant woman was treated with lamivudine and zidovudine. At 28 weeks of gestation, her hemoglobin had fallen to 4.6 g/dL with an mean corpuscular volume (MCV) of 126 microm. At 36 weeks the fetal biophysical profile was abnormal. A pale hydropic infant was delivered via emergency cesarean, with a hemoglobin of 2.1 gm and MCV of 131 microm. The newborn hemoglobin normalized after withdrawal of the neonatal retroviral therapy.


CONCLUSIONS
Maternal-fetal macrocytic anemia may complicate antiretroviral therapy.
Myers
Stephen A
SA
Department of Obstetrics & Gynecology, University of Kansas Medical Center, Kansas City, Kansas 66160-7316, USA. smyers3@kumc.edu
Torrente
Sandra
S
Hinthorn
Daniel
D
Clark
Perry L
PL
D000328:Adult; D000748:Anemia, Macrocytic / Q000139:chemically induced* / Q000196:embryology; D019380:Anti-HIV Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002585:Cesarean Section; D004359:Drug Therapy, Combination; D005260:Female; D005315:Fetal Diseases / Q000139:chemically induced*; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D019259:Lamivudine / Q000009:adverse effects / Q000627:therapeutic use; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000139:chemically induced*; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy*; D011256:Pregnancy Outcome; D019562:Viral Load; D015215:Zidovudine / Q000009:adverse effects / Q000627:therapeutic use
D019380:Anti-HIV Agents; D019259:Lamivudine; D015215:Zidovudine