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Maternal Tenofovir Disoproxil Fumarate Use in Pregnancy and Growth Outcomes among HIV-Exposed Uninfected Infants in Kenya

机译:肯尼亚接受艾滋病毒暴露的未感染婴儿的孕产妇替诺福韦酯富马酸盐富马酸酯的使用

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摘要

Background. Tenofovir disoproxil fumarate (TDF) is commonly used in antiretroviral treatment (ART) and preexposure prophylaxis regimens. We evaluated the relationship of prenatal TDF use and growth outcomes among Kenyan HIV-exposed uninfected (HEU) infants. Materials and Methods. We included PCR-confirmed HEU infants enrolled in a cross-sectional survey of mother-infant pairs conducted between July and December 2013 in Kenya. Maternal ART regimen during pregnancy was determined by self-report and clinic records. Six-week and 9-month z-scores for weight-for-age (WAZ), weight-for-length (WLZ), length-for-age (LAZ), and head circumference-for-age (HCAZ) were compared among HEU infants with and without TDF exposure using t-tests and multivariate linear regression models. Results. Among 277 mothers who received ART during pregnancy, 63% initiated ART before pregnancy, of which 89 (32%) used TDF. No differences in birth weight (3.0 kg versus 3.1 kg, p = 0.21) or gestational age (38 weeks versus 38 weeks, p = 0.16) were detected between TDF-exposed and TDF-unexposed infants. At 6 weeks, unadjusted mean WAZ was lower among TDF-exposed infants (−0.8 versus −0.4, p = 0.03), with a trend towards association in adjusted analyses (p = 0.06). There were no associations between prenatal TDF use and WLZ, LAZ, and HCAZ in 6-week or 9-month infant cohorts. Conclusion. Maternal TDF use did not adversely affect infant growth compared to other regimens.
机译:背景。替诺福韦酯富马酸泰索非尔(TDF)通常用于抗逆转录病毒治疗(ART)和暴露前预防方案。我们评估了肯尼亚艾滋病毒暴露的未感染(HEU)婴儿中产前TDF使用与生长结局的关系。材料和方法。我们纳入了经PCR确认的HEU婴儿,这些婴儿参加了2013年7月至12月在肯尼亚进行的母婴对横断面调查。孕妇在怀孕期间的抗逆转录病毒疗法由自我报告和临床记录确定。比较了6周和9个月的z得分,分别为:年龄体重(WAZ),长度体重(WLZ),年龄长度(LAZ)和头围年龄(HCAZ)使用t检验和多元线性回归模型对患有和不患有TDF暴露的HEU婴儿进行比较。结果。在277名在妊娠期间接受抗逆转录病毒治疗的母亲中,有63%的人在妊娠前开始接受抗逆转录病毒治疗,其中89位(32%)使用了TDF。在暴露于TDF的婴儿和未暴露于TDF的婴儿中,出生体重(3.0千克/公斤对3.1千克/公斤,P = 0.21)或胎龄(38周对38周,P = 0.16)没有差异。在6周时,暴露于TDF的婴儿中未经调整的平均WAZ较低(-0.8对-0.4,p = 0.03),在调整后的分析中呈关联趋势(p = 0.06)。在6周或9个月的婴儿队列中,产前TDF的使用与WLZ,LAZ和HCAZ之间没有关联。结论。与其他方案相比,母体使用TDF对婴儿的生长没有不利影响。

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