title: Influence of new antiretrovirals on hematological toxicity in HIV-exposed uninfected infants.
abstract: Maternal combined antiretroviral therapy (cART) successfully prevents HIV mother-to-child transmission but also causes hematological toxicity in the HIV-exposed uninfected (HEU) infant. We performed a single-center prospective observational study. Hematological toxicity during the first year of life (at 3 and 6 weeks, and 3, 6, and 12 months) was compared between HEU infants born in two different time periods: P1 (2000-2001) and P2 (2007-2013). Mother-infant pairs in P1 (n = 55) and P2 (n = 48) mainly differed in maternal ethnic origin, HIV route of transmission, and cART regimens. Anemia and neutropenia were both less common in P2 than P1, albeit not significantly. Earlier normalization of red blood cell mean corpuscular volume levels in P2 infants suggests that current cART maternal regimens and shorter neonatal prophylaxis are less toxic. Leukocyte, lymphocyte, and platelet counts remained within normal values during follow-up, without differences between groups.
  
  
  CONCLUSIONS
  New cART regimens have had very little impact on the hematological toxicity in HEU infants.
  
  
  BACKGROUND
  • Antiretroviral drugs during pregnancy and the neonatal period very effectively prevent mother-to-child transmission of HIV infection. • Hematological toxicity has been widely reported among HIV-exposed uninfected children. What is New: • In HIV-exposed uninfected children, hematological toxicity is still mainly caused by exposure to zidovudine. • New antiretroviral drugs have very little impact on hematological toxicity among HIV-exposed uninfected children.
authors.affiliation: Infectious Diseases Unit, Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Passeig Sant Joan de Déu 2, 08950, Esplugues, Spain.
authors.forename: Núria
authors.initials: N
authors.lastname: Rovira
authors.affiliation: Infectious Diseases Unit, Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Passeig Sant Joan de Déu 2, 08950, Esplugues, Spain.
authors.forename: Antoni
authors.initials: A
authors.lastname: Noguera-Julian
authors.affiliation: Pediatric Hematology and Oncology Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain.
authors.forename: Susana
authors.initials: S
authors.lastname: Rives
authors.affiliation: Pediatric Hematology and Oncology Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain.
authors.forename: Rubén
authors.initials: R
authors.lastname: Berrueco
authors.affiliation: Pediatrics Department, Hospital Universitari Joan XXIII, Carrer Dr. Mallafrè Guasch 4, 43005, Tarragona, Spain.
authors.forename: Rebeca
authors.initials: R
authors.lastname: Lahoz
authors.affiliation: Infectious Diseases Unit, Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Passeig Sant Joan de Déu 2, 08950, Esplugues, Spain. cfortuny@hsjdbcn.org.
authors.forename: Clàudia
authors.initials: C
authors.lastname: Fortuny
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects*; D044966:Anti-Retroviral Agents / Q000009:adverse effects*; D016009:Chi-Square Distribution; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000517:prevention & control / Q000635:transmission*; D006402:Hematologic Diseases / Q000139:chemically induced*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008297:Male; D011247:Pregnancy; D011446:Prospective Studies; D015215:Zidovudine / Q000009:adverse effects*
chemical_list: D019380:Anti-HIV Agents; D044966:Anti-Retroviral Agents; D015215:Zidovudine
keywords: Anemia; Antiretrovirals; HIV-exposed uninfected infant; Hematological toxicity; Mother-to-child transmission