人类免疫缺陷病毒暴露的未感染婴儿的新生儿听力筛查

Journal of AIDS and immune research Pub Date : 2016-01-01 Epub Date: 2016-09-05
P Torre, B Zeldow, T J Yao, H J Hoffman, G K Siberry, M U Purswani, T Frederick, S A Spector, P L Williams
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引用次数: 0

摘要

围产期HIV感染和先天性巨细胞病毒(CMV)感染可能增加听力损失的风险。我们研究了1435名参加ART毒性监测(SMARTT)研究的儿童HIV/AIDS队列研究(PHACS)网络,这是一项关于子宫内抗逆转录病毒(ARV)暴露安全性的前瞻性研究。我们确定了围产期hiv暴露的未感染(HEU)新生儿接受额外听力检测的比例,并评估了子宫内ARV暴露与新生儿听力筛查结果之间的关系。采用嵌套病例对照设计,我们还检查了有和没有筛查转诊的先天性巨细胞病毒感染婴儿。先天性巨细胞病毒感染是通过巢式PCR检测出生14天内获得的外周血单个核细胞的巨细胞病毒DNA来确定的。在1435名婴儿中(70%为黑人,31%为西班牙裔,51%为男性),45名(3.1%)未通过听力筛查,并被转诊进行进一步的听力检测。基于控制母亲使用烟草和耳毒性药物的精确逻辑回归模型,妊娠早期暴露于替诺福韦与新生儿听力筛查转诊的低几率相关[调整优势比(aOR) = 0.41, 95%可信区间(CI): 0.14-1.00]。阿扎那韦暴露与新生儿筛查转诊的较高几率相关,尽管没有达到显著性[aOR = 1.84, 95% CI: 0.92-3.56]。产妇使用抗逆转录病毒药物可能对新生儿听力筛查产生不同的影响。这些结果强调了听力学家了解HEU儿童子宫内抗逆转录病毒暴露的重要性,因为这些儿童的转诊率可能更高。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Newborn Hearing Screenings in Human Immunodeficiency Virus-Exposed Uninfected Infants.

Newborn Hearing Screenings in Human Immunodeficiency Virus-Exposed Uninfected Infants.

Perinatal HIV infection and congenital cytomegalovirus (CMV) infection may increase the risk for hearing loss. We examined 1,435 infants enrolled in the Surveillance Monitoring of ART Toxicities (SMARTT) study of the Pediatric HIV/AIDS Cohort Study (PHACS) network, a prospective study of the safety of in utero antiretroviral (ARV) exposures. We determined the proportion of perinatally HIV-exposed uninfected (HEU) newborns who were referred for additional hearing testing, and evaluated the association between in utero ARV exposures and newborn hearing screening results. Using a nested case-control design, we also examined congenital CMV infection in infants with and without screening referral. Congenital CMV infection was determined based on CMV DNA detection using a nested PCR assay in peripheral blood mononuclear cells obtained within 14 days of birth. Among the 1,435 infants (70% black, 31% Hispanic, 51% male), 45 (3.1%) did not pass the hearing screen and were referred for further hearing testing. Based on exact logistic regression models controlling for maternal use of tobacco and ototoxic medications, first trimester exposure to Tenofovir was associated with lower odds of a newborn hearing screening referral [adjusted odds ratio (aOR) = 0.41, 95% confidence interval (CI): 0.14-1.00]. Exposure to Atazanavir was linked to higher odds of newborn screening referral, although not attaining significance [aOR = 1.84, 95% CI: 0.92-3.56]. Maternal ARV use may have varying effects on newborn hearing screenings. These results highlight the importance for audiologists to be knowledgeable of in utero ARV exposures in HEU children because of the possibility of higher referrals in these children.

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