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在生命早期接受拉米夫定或洛匹那韦/利托那韦 1 年 HIV 预防治疗的儿童,其生长、临床和神经发育结局在学龄期相似。

Growth, clinical and neurodevelopmental outcomes at school age are similar for children who received 1-year lamivudine or lopinavir/ritonavir HIV prophylaxis in early life.

机构信息

Pathogenesis and Control of Chronic and Emerging Infections, INSERM U1058, Université de Montpellier, Etablissement Français du Sang, Université des Antilles, 60, rue de Navacelles, 34394, Montpellier Cedex, France.

University of Fort Hare, East London, South Africa.

出版信息

Sci Rep. 2021 Feb 4;11(1):3173. doi: 10.1038/s41598-021-82762-8.


DOI:10.1038/s41598-021-82762-8
PMID:33542437
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7862474/
Abstract

In the ANRS 12174 trial, HIV-exposed uninfected African neonates who received lopinavir-ritonavir (LPV/r) prophylaxis for 1 year exhibited slower growth from birth to week 50 compared with those receiving lamivudine (3TC). We assessed whether this difference in growth persisted over time, and was accompanied by differences in neuropsychological and clinical outcomes. Between February 2017 and February 2018, we conducted a cross-sectional clinical evaluation among former trial participants who completed the 50-week follow-up and who were not HIV-infected. In addition to clinical examination, neuropsychological outcomes were assessed using the tests Kaufman-ABCII, Test of Variables of Attention, Movement Assessment Battery for Children and the Strengths and Difficulties questionnaire, parent version. Of 1101 eligible children, aged 5-7 years, 553 could be traced and analysed (274 in the LPV/r and 279 in the 3TC groups). Growth, clinical and neuropsychological outcomes did not differ between treatment groups. At school age, children exposed to LPV/r and 3TC at birth for 1 year had comparable growth and neuropsychological outcomes without evidence of long-term side-effects of LPV/r. It provides reassuring data on clinical outcomes for all HIV-infected children treated with this antiretroviral drug in early life.

摘要

在 ANRS 12174 试验中,接受洛匹那韦利托那韦(LPV/r)预防治疗 1 年的 HIV 暴露未感染的非洲新生儿在出生到 50 周期间的生长速度较接受拉米夫定(3TC)治疗的婴儿慢。我们评估了这种生长差异是否持续存在,以及是否伴有神经心理学和临床结局的差异。在 2017 年 2 月至 2018 年 2 月期间,我们对完成 50 周随访且未感染 HIV 的前试验参与者进行了横断面临床评估。除了临床检查外,我们还使用 Kaufman-ABCII、注意力变量测试、儿童运动评估电池和父母版优势和困难问卷评估神经心理学结局。在 1101 名符合条件的 5-7 岁儿童中,有 553 名可以追踪和分析(LPV/r 组 274 名,3TC 组 279 名)。治疗组之间的生长、临床和神经心理学结局没有差异。在学龄期,出生时接受 LPV/r 和 3TC 治疗 1 年的儿童在生长和神经心理学结局方面具有可比性,没有 LPV/r 长期副作用的证据。这为所有在生命早期接受这种抗逆转录病毒药物治疗的 HIV 感染儿童提供了令人安心的临床结局数据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af38/7862474/fdc6dccb8294/41598_2021_82762_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af38/7862474/e365ec266341/41598_2021_82762_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af38/7862474/fdc6dccb8294/41598_2021_82762_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af38/7862474/e365ec266341/41598_2021_82762_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af38/7862474/fdc6dccb8294/41598_2021_82762_Fig2_HTML.jpg

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[1]
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[2]
Growth differences by school-age and adolescence according to in utero and peripartum antiretroviral therapy exposure among Ugandan children.

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[3]
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[4]
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[5]
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本文引用的文献

[1]
A new plan for extended paediatric HIV testing is needed in Africa.

Lancet Glob Health. 2019-12

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Neurodevelopmental effects of ante-partum and post-partum antiretroviral exposure in HIV-exposed and uninfected children versus HIV-unexposed and uninfected children in Uganda and Malawi: a prospective cohort study.

Lancet HIV. 2019-5-20

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Lancet HIV. 2019-2-24

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