title: CLEFT PALATE IN HIV-EXPOSED NEWBORNS OF MOTHERS ON HIGHLY ACTIVE ANTIRETROVIRAL THERAPY.
abstract: OBJECTIVE
  Cleft lip/palate, though rare, is the commonest head and neck congenital malformation. Both genetic and environmental factors have been implicated in the aetiopathogenesis but the role ofin-uteroexposure to human immunodeficiency virus (HIV) and highly active antiretroviral therapy (HAART) is still being investigated. This short communication reports the occurrence of cleft palate in three newborns exposedin-uteroto HIV and HAART.
  
  
  METHODS
  This is a case series of HIV-exposed newborns observed to have cleft palate among a larger cohort of HIV-exposed and unexposed newborns in a study evaluating the effect of HIV infection and HAART on newborn hearing. The Risk Ratio (RR) was calculated to detect a potential association betweenin-uteroexposure to Efavirenz containing ART and cleft palate.
  
  
  RESULTS
  Three HIV-exposed newborns with cleft palate were identified during hearing screening performed on 126 HIV-exposed and 121 HIV unexposed newborns. Two had exposure to tenofovir+lamivudine+efavirenz (TDF+3TC+EFV) while the third had exposure to zidovudine+lamivudine+nevirapine (ZDV+3TC+NVP) during the first trimester. There was no statistically significant association between presence of cleft palate and exposure to an EFV containing HAART regimen (p=0.07, RR=10.95 [0.94-126.84]).
  
  
  CONCLUSIONS
  This communication highlights the possible aetiologic role of HAART in cleft palate, the need for further prospective follow-up studies and establishment of antiretroviral pregnancy, birth and neonatal registries.
authors: Department of Otorhinolaryngology, College of Medicine, University of Ibadan, Nigeria.
authors: Ayotunde
authors: A
authors: James
authors: Department of Paediatrics, College of Medicine, University of Ibadan, Nigeria.
authors: Babatunde
authors: B
authors: Oluwatosin
authors: Department of Virology, College of Medicine, University of Ibadan, Nigeria ; MEDICAL EDUCATION PARTNERSHIP IN NIGERIA ; PRESIDENT'S EMERGENCY PLAN FOR AIDS RELIEF - AIDS PREVENTION INITIATIVE NIGERIA (PEPFAR-APIN PLUS).
authors: Georgina
authors: G
authors: Njideka
authors: Center for Global Health, Feinberg School of Medicine, Northwestern University, Chicago, USA.
authors: Babafemi
authors: Department of Otorhinolaryngology, College of Medicine, University of Ibadan, Nigeria.
authors: Onyekwere George
authors: OG
authors: Benjamin
authors: Department of Virology, College of Medicine, University of Ibadan, Nigeria ; MEDICAL EDUCATION PARTNERSHIP IN NIGERIA ; PRESIDENT'S EMERGENCY PLAN FOR AIDS RELIEF - AIDS PREVENTION INITIATIVE NIGERIA (PEPFAR-APIN PLUS).
authors: David
authors: D
authors: Olufemi
authors: Center for Global Health, Feinberg School of Medicine, Northwestern University, Chicago, USA.
authors: Robert
authors: R
authors: Leo
authors: Department of Obstetrics and Gynaecology, College of Medicine, University of Ibadan, Nigeria ; MEDICAL EDUCATION PARTNERSHIP IN NIGERIA ; PRESIDENT'S EMERGENCY PLAN FOR AIDS RELIEF - AIDS PREVENTION INITIATIVE NIGERIA (PEPFAR-APIN PLUS).
authors: Isaac
authors: I
authors: Folorunso
authors: Department of Immunology & Infectious Diseases, Harvard School of Public Health, Boston, MA, USA.
authors: Phylis
authors: Department of Paediatrics, College of Medicine, University of Ibadan, Nigeria ; MEDICAL EDUCATION PARTNERSHIP IN NIGERIA ; PRESIDENT'S EMERGENCY PLAN FOR AIDS RELIEF - AIDS PREVENTION INITIATIVE NIGERIA (PEPFAR-APIN PLUS).
authors: Olusegun
authors: O
authors: Olusina
keywords: Cleft palate; efavirenz; highly active antiretroviral therapy (HAART); human immunodeficiency virus (HIV); nevirapine; newborns
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