Antiretroviral Therapy in Relation to Birth Outcomes among HIV-infected Women: A Cohort Study.
Although the beneficial effects of antiretroviral (ARV) therapy for preventing mother-to-child transmission are indisputable, studies in developed and developing countries have reported conflicting findings on the association between ARV exposure and adverse birth outcomes. We conducted a prospective observational study at 10 human immunodeficiency virus (HIV) care and treatment centers in Dar es Salaam, Tanzania. Multivariate log-binomial regression was used to investigate the associations between ARV use and adverse birth outcomes among HIV-negative HIV-exposed infants. Our findings demonstrate an increased risk of adverse birth outcomes associated with the use of highly active antiretroviral therapy during pregnancy. Further studies are needed to investigate the underlying mechanisms and identify the safest ARV regimens for use during pregnancy.
Department of Global Health and Population, Harvard T.H. Chan School of Public Health (HSPH), Boston, Massachusetts.
Nan
N
Li
Management and Development for Health, Dar es Salaam, Tanzania.
Mary Mwanyika
MM
Sando
Departments of Epidemiology, HSPH, Boston, Massachusetts Biostatistics, HSPH, Boston, Massachusetts.
Donna
D
Spiegelman
Biostatistics, HSPH, Boston, Massachusetts.
Ellen
E
Hertzmark
Department of Global Health and Population, Harvard T.H. Chan School of Public Health (HSPH), Boston, Massachusetts.
Enju
E
Liu
Management and Development for Health, Dar es Salaam, Tanzania.
David
D
Sando
Management and Development for Health, Dar es Salaam, Tanzania.
Lameck
L
Machumi
Management and Development for Health, Dar es Salaam, Tanzania.
Guerino
G
Chalamilla
Department of Global Health and Population, Harvard T.H. Chan School of Public Health (HSPH), Boston, Massachusetts Departments of Epidemiology, HSPH, Boston, Massachusetts Nutrition, HSPH, Boston, Massachusetts.
Wafaie
W
Fawzi
D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D005260:Female; D005865:Gestational Age; D015658:HIV Infections / Q000188:drug therapy* / Q000517:prevention & control / Q000635:transmission; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D016015:Logistic Models; D015999:Multivariate Analysis; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy*; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000139:chemically induced*; D011446:Prospective Studies; D013636:Tanzania / Q000453:epidemiology; D055815:Young Adult
D019380:Anti-HIV Agents
Africa; HIV; antiretroviral therapy; birth outcome