Department of Internal Medicine and Pediatrics, Massachusetts General Hospital, Boston, MA, USA.
J Acquir Immune Defic Syndr. 2011 Feb 1;56(2):131-8. doi: 10.1097/QAI.0b013e3181ffa4f5.
The impact of in utero exposure to highly active antiretroviral therapy (HAART) on longitudinal growth of HIV-uninfected infants is unknown.
The Mashi and Mma Bana PMTCT intervention trials enrolled HIV-infected pregnant women at four sites in Botswana. Breast-fed (BF), HIV-uninfected infants born at 37 weeks or greater were included in this analysis. Weight-for-age (WAZ), length-for-age (LAZ), and weight-for-length (WLZ) z-scores were calculated using World Health Organization Child Growth Standards. Mean z-scores were compared between in utero antiretroviral exposure groups using Student t test, response profiles analysis, and general linear mixed effects modeling.
Growth of 619 HAART-exposed and 440 zidovudine-exposed, HIV-uninfected infants was evaluated. Mean birth weights were 3.01 kg for HAART and 3.15 kg for zidovudine-exposed infants (P < 0.001) with lower mean birth WAZ, length-for-age (LAZ), and weight-for-length (WLZ) among HAART-exposed infants (all P < 0.001). HAART-exposed infants had greater improvement in WAZ and weight-for-length (WLZ) from birth through 2 months (P = 0.03, P < 0.001, respectively). The WAZ did not differ between groups from 3 through 6 months (P = 0.26). Length-for-age (LAZ) remained lower in HAART-exposed infants but the incidence of wasting or stunting did not differ between exposure groups.
Lower weights in HAART-exposed uninfected infants at birth were rapidly corrected during the first 6 months of life.
宫内暴露于高效抗逆转录病毒疗法（HAART）对 HIV 未感染婴儿的纵向生长的影响尚不清楚。
Mashi 和 Mma Bana PMTCT 干预试验在博茨瓦纳的四个地点招募了感染 HIV 的孕妇。本分析纳入了在 37 周或以上时出生的母乳喂养（BF）、HIV 未感染的婴儿。使用世界卫生组织儿童生长标准计算体重年龄（WAZ）、身长年龄（LAZ）和体重身长（WLZ）z 评分。使用学生 t 检验、反应谱分析和广义线性混合效应模型比较宫内抗逆转录病毒暴露组之间的平均 z 评分。
评估了 619 名接受 HAART 暴露和 440 名接受齐多夫定暴露、HIV 未感染的婴儿的生长情况。HAART 组和齐多夫定组的平均出生体重分别为 3.01kg 和 3.15kg（P < 0.001），HAART 组的出生时 WAZ、LAZ 和 WLZ 平均值较低（均 P < 0.001）。HAART 暴露组婴儿从出生到 2 个月时 WAZ 和体重身长（WLZ）的改善更大（P = 0.03，P < 0.001）。从 3 个月到 6 个月时，两组间的 WAZ 无差异（P = 0.26）。HAART 暴露组婴儿的 LAZ 仍较低，但两组间消瘦或发育迟缓的发生率无差异。
HAART 暴露的未感染婴儿出生时体重较低，但在生命的前 6 个月内迅速得到纠正。
