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Infant Neutropenia Associated with Breastfeeding During Maternal Antiretroviral Treatment for Prevention of Mother-to-Child Transmission of HIV.母婴抗逆转录病毒治疗预防HIV母婴传播期间母乳喂养相关的婴儿中性粒细胞减少症
Retrovirology (Auckl). 2014;6:1-5. doi: 10.4137/RRt.s13267. Epub 2014 Feb 13.
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Antiretroviral interventions for preventing breast milk transmission of HIV.预防母乳传播艾滋病毒的抗逆转录病毒干预措施。
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Antiretroviral therapy (ART) for treating HIV infection in ART-eligible pregnant women.用于治疗符合抗逆转录病毒治疗条件的孕妇艾滋病毒感染的抗逆转录病毒疗法。
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Triple antiretroviral compared with zidovudine and single-dose nevirapine prophylaxis during pregnancy and breastfeeding for prevention of mother-to-child transmission of HIV-1 (Kesho Bora study): a randomised controlled trial.三重抗逆转录病毒治疗与齐多夫定和单剂量奈韦拉平预防方案在妊娠期和哺乳期用于预防 HIV-1 母婴传播的比较（肯尼亚母婴传播预防研究）：一项随机对照试验。
Lancet Infect Dis. 2011 Mar;11(3):171-80. doi: 10.1016/S1473-3099(10)70288-7. Epub 2011 Jan 13.
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Antiretrovirals for reducing the risk of mother-to-child transmission of HIV infection.用于降低艾滋病毒感染母婴传播风险的抗逆转录病毒药物。
Cochrane Database Syst Rev. 2011 Jul 6(7):CD003510. doi: 10.1002/14651858.CD003510.pub3.
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Maternal and infant antiretroviral regimens to prevent postnatal HIV-1 transmission: 48-week follow-up of the BAN randomised controlled trial.母亲和婴儿抗逆转录病毒方案预防产后 HIV-1 传播：BAN 随机对照试验的 48 周随访。
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Triple-antiretroviral prophylaxis to prevent mother-to-child HIV transmission through breastfeeding--the Kisumu Breastfeeding Study, Kenya: a clinical trial.三药联合抗逆转录病毒预防方案用于预防肯尼亚基苏木母乳喂养传播母婴 HIV 感染的效果：一项临床试验
PLoS Med. 2011 Mar;8(3):e1001015. doi: 10.1371/journal.pmed.1001015. Epub 2011 Mar 29.
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PedVacc 002: a phase I/II randomized clinical trial of MVA.HIVA vaccine administered to infants born to human immunodeficiency virus type 1-positive mothers in Nairobi.PedVacc 002：一项针对内罗毕地区人类免疫缺陷病毒1型阳性母亲所生婴儿接种MVA.HIVA疫苗的I/II期随机临床试验。
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本文引用的文献

1
Cotrimoxazole prophylaxis and risk of severe anemia or severe neutropenia in HAART-exposed, HIV-uninfected infants.复方新诺明预防治疗与抗反转录病毒治疗暴露、HIV 阴性婴儿重度贫血或重度中性粒细胞减少症的风险。
PLoS One. 2013 Sep 23;8(9):e74171. doi: 10.1371/journal.pone.0074171. eCollection 2013.
2
Extended prophylaxis with nevirapine and cotrimoxazole among HIV-exposed uninfected infants is well tolerated.暴露于 HIV 但未感染的婴儿中，用奈韦拉平与复方新诺明进行延长预防，耐受性良好。
AIDS. 2012 Jan 28;26(3):325-33. doi: 10.1097/QAD.0b013e32834e892c.
3
Triple antiretroviral compared with zidovudine and single-dose nevirapine prophylaxis during pregnancy and breastfeeding for prevention of mother-to-child transmission of HIV-1 (Kesho Bora study): a randomised controlled trial.三重抗逆转录病毒治疗与齐多夫定和单剂量奈韦拉平预防方案在妊娠期和哺乳期用于预防 HIV-1 母婴传播的比较（肯尼亚母婴传播预防研究）：一项随机对照试验。
Lancet Infect Dis. 2011 Mar;11(3):171-80. doi: 10.1016/S1473-3099(10)70288-7. Epub 2011 Jan 13.
4
Establishment of haematological and immunological reference values for healthy Tanzanian children in Kilimanjaro Region.建立 Kilimanjaro 地区坦桑尼亚健康儿童的血液学和免疫学参考值。
Trop Med Int Health. 2010 Sep;15(9):1011-21. doi: 10.1111/j.1365-3156.2010.02585.x. Epub 2010 Jul 15.
5
Antiretroviral regimens in pregnancy and breast-feeding in Botswana.博茨瓦纳妊娠和哺乳期的抗逆转录病毒方案。
N Engl J Med. 2010 Jun 17;362(24):2282-94. doi: 10.1056/NEJMoa0907736.
6
Hematologic and hepatic toxicities associated with antenatal and postnatal exposure to maternal highly active antiretroviral therapy among infants.婴儿产前和产后接触母体高效抗逆转录病毒疗法相关的血液学和肝脏毒性。
AIDS. 2008 Aug 20;22(13):1633-40. doi: 10.1097/QAD.0b013e328307a029.
7
Extended-dose nevirapine to 6 weeks of age for infants to prevent HIV transmission via breastfeeding in Ethiopia, India, and Uganda: an analysis of three randomised controlled trials.在埃塞俄比亚、印度和乌干达，对婴儿延长奈韦拉平用药至6周龄以预防通过母乳喂养传播艾滋病毒：三项随机对照试验的分析
Lancet. 2008 Jul 26;372(9635):300-13. doi: 10.1016/S0140-6736(08)61114-9.
8
Hematologic effects of maternal antiretroviral therapy and transmission prophylaxis in HIV-1-exposed uninfected newborn infants.母亲抗逆转录病毒疗法及对暴露于HIV-1但未感染的新生儿进行传播预防的血液学影响。
J Acquir Immune Defic Syndr. 2007 May 1;45(1):43-51. doi: 10.1097/QAI.0b013e318042d5e3.
9
Effect of perinatal antiretroviral drug exposure on hematologic values in HIV-uninfected children: An analysis of the women and infants transmission study.围产期抗逆转录病毒药物暴露对未感染HIV儿童血液学指标的影响：妇女和婴儿传播研究分析
J Infect Dis. 2006 Oct 15;194(8):1089-97. doi: 10.1086/507645. Epub 2006 Sep 11.
10
Range of normal neutrophil counts in healthy zimbabwean infants: implications for monitoring antiretroviral drug toxicity.津巴布韦健康婴儿中性粒细胞计数的正常范围：对抗逆转录病毒药物毒性监测的意义。
J Acquir Immune Defic Syndr. 2006 Aug 1;42(4):460-3. doi: 10.1097/01.qai.0000224975.45091.a5.

母婴抗逆转录病毒治疗预防HIV母婴传播期间母乳喂养相关的婴儿中性粒细胞减少症

Infant Neutropenia Associated with Breastfeeding During Maternal Antiretroviral Treatment for Prevention of Mother-to-Child Transmission of HIV.

作者信息

Njuguna Irene, Reilly Marie, Jaoko Walter, Gichuhi Christine, Ambler Gwen, Maleche-Obimbo Elizabeth, Lohman-Payne Barbara, Hanke Tomáš, John-Stewart Grace

机构信息

Department of Pediatrics and Child Health, University of Nairobi, Nairobi, Kenya.

Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden.

出版信息

Retrovirology (Auckl). 2014;6:1-5. doi: 10.4137/RRt.s13267. Epub 2014 Feb 13.

DOI:10.4137/RRt.s13267
PMID:31708646
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6839413/
Abstract

Maternal antiretroviral treatment (ART) is recommended for prevention of mother-to-child HIV-1 transmission (PMTCT), including in women with high CD4 cell counts. Within a pediatric HIV-1 vaccine trial PedVacc 002, we assessed hematologic profiles of infants born to mothers receiving ART. All mothers had CD4 cell counts of >350 mm; 93% received zidovudine-containing ART; infants received nevirapine up to 6 weeks and cotrimoxazole after 6 weeks. Among 84 infants at 19 weeks, 58% had hematologic toxicity; 44% had neutropenia and 23% had anemia. Breastfeeding was associated with 3.8-fold higher risk of neutropenia (RR 3.8, 95% CI 1.03-14.1, p = 0.008). Hematologic monitoring and PMTCT regimen selection are important for optimizing infant outcomes.

摘要

建议采用孕产妇抗逆转录病毒治疗（ART）来预防母婴HIV-1传播（PMTCT），包括CD4细胞计数高的女性。在一项儿科HIV-1疫苗试验PedVacc 002中，我们评估了接受ART治疗的母亲所生婴儿的血液学特征。所有母亲的CD4细胞计数均>350/mm³；93%接受含齐多夫定的ART治疗；婴儿在6周龄前接受奈韦拉平治疗，6周龄后接受复方新诺明治疗。在19周龄的84名婴儿中，58%出现血液学毒性；44%出现中性粒细胞减少，23%出现贫血。母乳喂养与中性粒细胞减少风险高3.8倍相关（相对风险3.8，95%置信区间1.03 - 14.1，p = 0.008）。血液学监测和PMTCT方案选择对于优化婴儿结局很重要。