Adverse effects of perinatal zidovudine exposure on HIV-infected infants

A report published in the July issue of the Journal of Infectious Diseases compared the clinical progression of HIV disease, among infected infants either exposed or unexposed to zidovudine pre or perinatally.

Dr Louise Kuhn’s group followed 325 HIV-infected children born during 1986 to 1997 in a multicentre observational cohort study, until AIDS diagnosis or death. Among the children who did not receive antiretroviral therapy before AIDS diagnosis, 44% of the zidovudine-exposed group (vs. 24% of the unexposed) progressed to AIDS or died before the age of 12 months. An alarming 1.8 fold increased risk.

Unsurprisingly none of the infected children treated with multi drug therapy in their first year progressed to AIDS or died during this period, regardless of their prenatal or perinatal zidovudine exposure.

Comment

It is speculated that the mothers using ZDV prophylaxis and subsequently transmitted may have had and therefore transmitted more aggressive disease – but no maternal viral load data was available. It is reassuring that HAART for the children was subsequently effective.

Kuhn L et al. Disease progression and early viral dynamics in HIV-infected children exposed to zidovudine during prenatal and perinatal periods. J Infect Dis. 2000 Jul;182(1):104-11.