Prevention of vertical transmission and side effects of antiretroviral therapy in children born to HIV-positive South Eastern area of Santiago, Chile: 15-years perspective
Peña, Aía.; Cerón, Iés.; Budnik, I.; Barttlet, D.; Cataldo, K.; Fernández, A.M.; Ramírez, Aía.; Lasso, Mín.
Revista Chilena de Infectologia Organo Oficial de la Sociedad Chilena de Infectologia 30(6): 644-652
2013
ISSN/ISBN: 0716-1018 PMID: 24522309 DOI: 10.4067/s0716-10182013000600012Document Number: 581128
Antiretroviral therapy (ART) has shown to be an effective measure in decreasing HIV vertical transmission (VT). Nevertheless, it is not free from adverse effects in the newborn: risk of prematurity, low birth weight, metabolic disorders, among others. Despite the importance of the subject, there are few national data that analyze the problem. We performed a retrospective analysis of a cohort of HIV positive mother/child binomial, followed between 1995 and 2010. Ninety-four pregnancies and 96 children (2 twin pregnancies) were analyzed. The rate of VT was 2.1%. Adverse effects attributed to ART were found on 85.4% of the newborn; highlighting the presence of anemia (70.8%) and several metabolic disorders [elevated lactate without acidosis (29.2%), lactic acidosis (12.5%), hyperkalemia (14.6%), metabolic acidosis (9.4%)]. Maternal exposure to protease inhibitors proved to be an independent risk factor for the development of metabolic disorders in newborns (OR 0.15 [0.04-0.48], p < 0.01). In our series, ART was effective in reducing the VT, however exposed newborns showed a high frequency of adverse effects, so it is advisable to implement programs for monitoring these patients to prevent sequelae.