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

• Published in: Infectious Diseases in Obstetrics and Gynecology Vol. 2015; no. 2015; pp. 29 - 37
• Main Authors: McGrath, Christine J., John-Stewart, Grace C., Katana, Abraham, Odeny, Beryne, Kinuthia, John, Singa, Benson, Langat, Agnes, Pintye, Jillian, Nganga, Lucy
• Format: Journal Article
• Language: English
• Published: Cairo, Egypt Hindawi Limiteds 2015; Hindawi Publishing Corporation; John Wiley & Sons, Inc; Hindawi Limited
• Subjects: Adult; Anti-HIV Agents - pharmacology; Anti-HIV Agents - therapeutic use; Antibiotic Prophylaxis; Birth Weight - drug effects; CD4 Lymphocyte Count; Development; Dosage and administration; Drug therapy; Female; Health aspects; HIV infection; HIV infection in pregnancy; HIV Infections - drug therapy; HIV Infections - epidemiology; HIV Infections - prevention & control; Humans; Infant; Infant, Newborn; Infants; Infectious Disease Transmission, Vertical - prevention & control; Kenya - epidemiology; Maternal-fetal exchange; Patient outcomes; Physiological aspects; Pregnancy; Pregnancy Complications, Infectious - drug therapy; Pregnancy Complications, Infectious - epidemiology; Pregnancy Complications, Infectious - prevention & control; Pregnancy Outcome - epidemiology; Prenatal influences; Retrospective Studies; Tenofovir; Tenofovir - pharmacology; Tenofovir - therapeutic use; Young Adult; Kenya
• ISSN: 1064-7449; 1098-0997
• DOI: 10.1155/2015/276851

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.