美国队列中第一胎接触新型抗逆转录病毒药物与先天性畸形。

IF 3.4 2区 医学 Q3 IMMUNOLOGY
AIDS Pub Date : 2024-09-01 Epub Date: 2024-06-11 DOI:10.1097/QAD.0000000000003955
Kelly Fung, Sonia Hernandez-Diaz, Rebecca Zash, Ellen G Chadwick, Russell B Van Dyke, Carly Broadwell, Jennifer Jao, Kathleen Powis, Lynn M Yee, Paige L Williams
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引用次数: 0

摘要

目的描述美国艾滋病病毒感染者所生婴儿在妊娠头三个月接触新型抗逆转录病毒药物与先天性畸形之间的关系:设计:参加抗逆转录病毒疗法毒性监测(SMARTT)研究的 HIV 感染者孕妇 2012-2022 年所生婴儿的纵向队列:方法:从孕产妇病历中抽取第一胎暴露于新型抗逆转录病毒药物的数据。经过培训的现场工作人员进行体格检查,并从婴儿医疗记录中摘录先天性畸形。研究人员使用亚特兰大大都会先天缺陷计划分类系统对异常进行分类。对接触和未接触每种抗逆转录病毒药物的婴儿在一岁前发现的主要先天畸形患病率进行了估算。在对潜在混杂因素进行调整后,使用广义估计方程模型估算出每种抗逆转录病毒暴露的主要先天性畸形的几率比(OR):结果:在 2034 名婴儿中,发现 135 名婴儿(6.6%;95% CI:5.6%-7.8%)有重大先天畸形。心血管异常(43 例)和肌肉骨骼异常(37 例)最为常见。先天性畸形的调整 ORs(95% CI)分别为:darunavir:1.03(0.62-1.72);raltegravir:0.91(0.46-1.81);rilpivirine:1.04(0.58-1.85);darunavir:1.与未接触过每种特定抗逆转录病毒药物的患者相比,elvitegravir 为 1.31(0.71-2.41),dolutegravir 为 0.76(0.37-1.57),bictegravir 为 0.34(0.05-2.51)。在对核苷/核苷酸骨架进行调整后,结果相似:令人欣慰的是,第一孕期接触过新型抗逆转录病毒药物的婴儿出现先天性畸形的几率与未接触过这些特定抗逆转录病毒药物的婴儿相比没有显著差异。需要通过更大规模的研究继续评估这些抗逆转录病毒药物,以证实这些发现。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
First-trimester exposure to newer antiretroviral agents and congenital anomalies in a US cohort.

Objective: To characterize associations of exposure to newer antiretroviral medications in the first trimester with congenital anomalies among infants born to persons with HIV in the United States.

Design: Longitudinal cohort of infants born 2012-2022 to pregnant persons with HIV enrolled in the Surveillance Monitoring for ART Toxicities (SMARTT) study.

Methods: First-trimester exposures to newer antiretrovirals (ARVs) were abstracted from maternal medical records. Trained site staff conducted physical exams and abstracted congenital anomalies from infant medical records. Investigators classified anomalies using the Metropolitan Atlanta Congenital Defects Program classification system. The prevalence of major congenital anomalies identified by age one year was estimated for infants exposed and unexposed to each ARV. Generalized estimating equation models were used to estimate the odds ratio (OR) of major congenital anomalies for each ARV exposure, adjusting for potential confounders.

Results: Of 2034 infants, major congenital anomalies were identified in 135 [6.6%; 95% confidence interval (CI): 5.6-7.8%]. Cardiovascular ( n  = 43) and musculoskeletal ( n  = 37) anomalies were the most common. Adjusted ORs (95% CI) of congenital anomalies were 1.03 (0.62-1.72) for darunavir, 0.91 (0.46-1.81) for raltegravir, 1.04 (0.58-1.85) for rilpivirine, 1.31 (0.71-2.41) for elvitegravir, 0.76 (0.37-1.57) for dolutegravir, and 0.34 (0.05-2.51) for bictegravir, compared to those unexposed to each specific ARV. Findings were similar after adjustment for nucleoside/nucleotide backbones.

Conclusions: The odds of congenital anomalies among infants with first-trimester exposure to newer ARVs did not differ substantially from those unexposed to these specific ARVs, which is reassuring. Continued evaluation of these ARVs with larger studies will be needed to confirm these findings.

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来源期刊
AIDS
AIDS 医学-病毒学
CiteScore
5.90
自引率
5.30%
发文量
478
审稿时长
3 months
期刊介绍: ​​​​​​​​​​​​​​​​​Publishing the very latest ground breaking research on HIV and AIDS. Read by all the top clinicians and researchers, AIDS has the highest impact of all AIDS-related journals. With 18 issues per year, AIDS guarantees the authoritative presentation of significant advances. The Editors, themselves noted international experts who know the demands of your work, are committed to making AIDS the most distinguished and innovative journal in the field. Submitted articles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.
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