title: Maternal antiretrovirals and hepatic enzyme, hematologic abnormalities among human immunodeficiency virus type 1-uninfected infants: the NISDI perinatal study.
abstract: OBJECTIVE
  To assess hepatic enzyme (HE) and hematologic abnormalities among human immunodeficiency virus-1-uninfected infants according to maternal antiretroviral regimen during pregnancy.
  
  
  METHODS
  In a prospective cohort, HE and hematologic values of human immunodeficiency virus-1-uninfected, term infants with hospital discharge (HD) within 6 days after birth were evaluated. Maternal antiretroviral regimens were categorized as: 1 or 2 nucleoside reverse transcription inhibitors (NRTIs), highly active antiretroviral therapy (HAART)/protease inhibitor (PI), or HAART/non-NRTI.
  
  
  RESULTS
  Among 503 infants, 63% and 24% had HE and hemoglobin abnormalities, respectively, at HD. Most or all HE and hemoglobin abnormalities (96-100%) were grade 1 or 2. At HD, infants with maternal HAART/PI or HAART/non-NRTI were more likely to have elevated HE [adjusted odds ratio (AOR): 1.9, 2.4, respectively] compared with infants whose mothers received 1 or 2 NRTIs. Infants with maternal HAART/PI were less likely to have abnormal hemoglobin values at HD (AOR, 0.5) when compared with those whose mothers received 1 or 2 NRTIs. Persistently abnormal hemoglobin and HE values decreased with time, such that <10% of infants had abnormalities at 6 months of age.
  
  
  CONCLUSIONS
  Maternal receipt of HAART regimens was associated with an increased risk of HE abnormalities, and maternal HAART/PI was associated with a lower risk of abnormal hemoglobin values, at HD. Abnormalities of HE and hemoglobin were generally mild and transient.
authors.affiliation: Department of Pediatrics, University of São Paulo, Ribeirão Preto, São Paulo, Brazil. mmmpinha@fmrp.usp.br
authors.forename: Marisa M
authors.initials: MM
authors.lastname: Mussi-Pinhata
authors.forename: Maria Aparecida C
authors.initials: MA
authors.lastname: Rego
authors.forename: Laura
authors.initials: L
authors.lastname: Freimanis
authors.forename: Fabiana M
authors.initials: FM
authors.lastname: Kakehasi
authors.forename: Daisy Maria
authors.initials: DM
authors.lastname: Machado
authors.forename: Edmundo M
authors.initials: EM
authors.lastname: Cardoso
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Read
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects* / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D017691:Caribbean Region; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000517:prevention & control; D015497:HIV-1 / Q000187:drug effects / Q000502:physiology; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D007843:Latin America; D008099:Liver / Q000201:enzymology*; D018743:Perinatal Care; D011247:Pregnancy; D018894:Reverse Transcriptase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D000637:Transaminases / Q000378:metabolism
chemical_list: D019380:Anti-HIV Agents; D006454:Hemoglobins; D018894:Reverse Transcriptase Inhibitors; D000637:Transaminases