title: Maternal Tenofovir Disoproxil Fumarate Use in Pregnancy and Growth Outcomes among HIV-Exposed Uninfected Infants in Kenya.
abstract: 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.
  
  
  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.
  
  
  CONCLUSIONS
  Maternal TDF use did not adversely affect infant growth compared to other regimens.
authors.affiliation: Department of Global Health, University of Washington, Seattle, WA 98104, USA; Department of Nursing, University of Washington, Seattle, WA 98195, USA.
authors.forename: Jillian
authors.initials: J
authors.lastname: Pintye
authors.affiliation: United States Centers for Disease Control and Prevention (CDC), Nairobi 00202, Kenya.
authors.forename: Agnes
authors.initials: A
authors.lastname: Langat
authors.affiliation: Center for Microbiology Research and Center for Clinical Research, Kenya Medical Research Institute, Nairobi 00202, Kenya.
authors.forename: Benson
authors.initials: B
authors.lastname: Singa
authors.affiliation: Department of Global Health, University of Washington, Seattle, WA 98104, USA; Department of Obstetrics & Gynecology, Kenyatta National Hospital, Nairobi 00202, Kenya.
authors.forename: John
authors.initials: J
authors.lastname: Kinuthia
authors.affiliation: Department of Global Health, University of Washington, Seattle, WA 98104, USA.
authors.forename: Beryne
authors.initials: B
authors.lastname: Odeny
authors.affiliation: United States Centers for Disease Control and Prevention (CDC), Nairobi 00202, Kenya.
authors.forename: Abraham
authors.initials: A
authors.lastname: Katana
authors.affiliation: United States Centers for Disease Control and Prevention (CDC), Nairobi 00202, Kenya.
authors.forename: Lucy
authors.initials: L
authors.lastname: Nganga
authors.affiliation: Department 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.
authors.forename: Grace
authors.initials: G
authors.lastname: John-Stewart
authors.affiliation: Department of Global Health, University of Washington, Seattle, WA 98104, USA; University of Texas Medical Branch, Galveston, TX 77555, USA.
authors.forename: Christine J
authors.initials: CJ
authors.lastname: McGrath
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000494:pharmacology / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D001724:Birth Weight / Q000187:drug effects*; D018791:CD4 Lymphocyte Count; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D007630:Kenya / Q000453:epidemiology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control; D011256:Pregnancy Outcome / Q000453:epidemiology; D012189:Retrospective Studies; D000068698:Tenofovir / Q000494:pharmacology / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents; D000068698:Tenofovir
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