Schlösser R, Linde R, Dunsch D, Reitter A, Haberl A, Bauer K
Zentrum für Kinder- und Jugendmedizin, Neonatologie, Klinikum der Johann-Wolfgang-Goethe Universität, Frankfurt am Main.
Z Geburtshilfe Neonatol. 2007 Dec;211(6):230-5. doi: 10.1055/s-2007-981405.
The aim of this study was to assess the frequency of side effects of antiretroviral treatment in transmission prophylaxis in preterm and near-term infants with a history of HIV-positive mothers.
A retrospective single-centre study of all neonates born to HIV-positive mothers between 2001 and 2005 and receiving antiretroviral prophylaxis was performed. Respiratory distress was documented as well as possible side effects from antiretroviral drug treatment, e. g., anaemia, need for transfusion, liver and kidney dysfunction, depression of white blood cell count, feeding problems and nosocomial infections. A comparison was made between a group of preterm infants of less than 35 weeks of gestation with one of near-term neonates of more than 34 weeks. To evaluate the influence of prematurity on the frequency of symptoms, a matched pairs group of 50 preterm infants was established as the control group.
Anaemia at birth (24 vs. 27 %), transient signs of liver impairment (24 vs. 16.5 %) or kidney dysfunction (4 vs. 0.8 %) as well as nosocomial infections were not significantly more frequent in the preterm group than in near-term group of HIV-exposed infants. Respiratory distress (56 vs. 13 %), postnatal anaemia (84 vs. 27 %). leucocytopenia (36 vs. 4 %), feeding problems (88 vs. 42 %), and blood transfusion (32 vs. 7 %) were more common in the preterm infants. The frequency of feeding problems remained markedly elevated when preterm HIV-exposed neonates were compared to preterm controls. Respiratory distress in near-term infants was seen in 13 % of the cases and 2.6 % of them had to be ventilated artificially. This was a higher frequency than in babies delivered by elective Caesarean section without maternal HIV history.
Transmission prophylaxis in offspring of HIV-positive mothers may give rise to adverse effects. Their frequency is higher in preterm infants than in near-term infants. However; this may be related to prematurity, and not to the antiretroviral treatment itself.
本研究旨在评估接受抗逆转录病毒治疗以预防母婴传播的早产及近足月HIV阳性母亲所生婴儿的副作用发生频率。
对2001年至2005年间出生的、其母亲为HIV阳性且接受抗逆转录病毒预防治疗的所有新生儿进行回顾性单中心研究。记录呼吸窘迫情况以及抗逆转录病毒药物治疗可能产生的副作用，如贫血、输血需求、肝肾功能障碍、白细胞计数降低、喂养问题及医院感染。将一组孕周小于35周的早产儿与一组孕周大于34周的近足月儿进行比较。为评估早产对症状发生频率的影响，设立了一个由50名早产儿组成的配对对照组。
早产组HIV暴露婴儿出生时贫血（24%对27%）、短暂肝功能损害迹象（24%对16.5%）或肾功能障碍（4%对0.8%）以及医院感染的发生频率并不显著高于近足月儿组。呼吸窘迫（56%对13%）、出生后贫血（84%对27%）、白细胞减少（36%对4%）、喂养问题（88%对42%）及输血（32%对7%）在早产儿中更为常见。与早产对照组相比，HIV暴露早产儿的喂养问题发生频率仍显著升高。近足月儿中13%出现呼吸窘迫，其中2.6%需人工通气。这一频率高于无母亲HIV病史的择期剖宫产分娩的婴儿。
HIV阳性母亲的子代接受预防母婴传播治疗可能会产生不良反应。其在早产儿中的发生频率高于近足月儿。然而，这可能与早产有关，而非抗逆转录病毒治疗本身。
