Department of Pediatrics, Montefiore Medical Center, Bronx, New York.
Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York.
J Pediatric Infect Dis Soc. 2018 May 15;7(2):e24-e29. doi: 10.1093/jpids/pix111.
Prevention of mother-to-child transmission of human immunodeficiency virus (HIV) with antiretroviral therapy (ART) has been highly successful. However, HIV-exposed uninfected (HIV-EU) infants might be at increased risk for low birth weight and/or preterm birth. We compared the birth weights and gestational ages of HIV-EU infants to those of HIV-unexposed control infants in Bronx, New York, an epicenter of the HIV epidemic in the United States.
This study was performed with a retrospective cohort of HIV-EU infants born at Montefiore Medical Center between 2008 and 2012 and HIV-unexposed control infants. Each HIV-EU infant was matched according to year of birth with 5 HIV-unexposed controls from the New York City Department of Health and Mental Hygiene birth certificate database. We used regression models to assess the association between HIV exposure and birth weight while controlling for potential confounders. A secondary analysis was performed to determine the association of maternal protease inhibitor-based ART use and birth weight among HIV-EU infants.
We included 155 HIV-EU infants born between 2008 and 2012 (51% female, 61% black, 32% Hispanic) and 775 HIV-unexposed infants. The mean (± standard deviation) unadjusted birth weights were 2971 ± 616 g (HIV-EU infants) and 3163 ± 644 g (HIV-unexposed infants) (P < .01). Multivariable regression revealed significantly lower birth weight for the HIV-EU infants (difference, -101.5 g [95% confidence interval, -181.4 to -21.6]). We found no difference in mean birth weight or gestational age with maternal protease inhibitor-based ART use when compared to the use of other regimens.
We found significantly lower birth weight among HIV-EU infants. Long-term prospective studies are necessary to determine the implications of this finding on infant growth and development.
抗逆转录病毒疗法（ART）在预防母婴传播人类免疫缺陷病毒（HIV）方面已取得巨大成功。然而，HIV 暴露但未感染（HIV-EU）的婴儿可能有更高的低出生体重和/或早产风险。我们比较了纽约布朗克斯区 HIV-EU 婴儿和 HIV 未暴露对照婴儿的出生体重和胎龄，该地区是美国 HIV 流行的一个中心。
本研究为回顾性队列研究，纳入了 2008 年至 2012 年在蒙特菲奥雷医疗中心出生的 HIV-EU 婴儿和 HIV 未暴露对照婴儿。根据出生年份，每位 HIV-EU 婴儿都与来自纽约市卫生和心理健康部门出生证明数据库的 5 名 HIV 未暴露对照婴儿相匹配。我们使用回归模型来评估 HIV 暴露与出生体重之间的关联，同时控制潜在的混杂因素。还进行了二次分析，以确定 HIV-EU 婴儿中母亲使用蛋白酶抑制剂为基础的 ART 与出生体重之间的关联。
我们纳入了 155 名 2008 年至 2012 年出生的 HIV-EU 婴儿（51%为女性，61%为黑人，32%为西班牙裔）和 775 名 HIV 未暴露的婴儿。未调整的平均出生体重分别为 2971 ± 616 g（HIV-EU 婴儿）和 3163 ± 644 g（HIV 未暴露婴儿）（P <.01）。多变量回归显示，HIV-EU 婴儿的出生体重明显较低（差值为-101.5 g [95%置信区间，-181.4 至-21.6]）。与使用其他方案相比，我们未发现使用基于蛋白酶抑制剂的母亲 ART 治疗与平均出生体重或胎龄之间存在差异。
我们发现 HIV-EU 婴儿的出生体重明显较低。需要进行长期前瞻性研究以确定这一发现对婴儿生长和发育的影响。
