Long-term effects of short-term perinatal exposure to antiretroviral drugs. Issue 2 (March 2009)

• Record Type: Journal Article
• Authors: Callens, Steven FJ
• Is Part Of: HIV therapy. Volume 3:Issue 2(2009)
• Page Start: 141
• Page End: 144
• Publication Date: 2009-03
• Subjects: antiretroviral -- children -- cohort -- genotoxicity -- long term -- prevention of mother-to-child-transmission -- safety -- teratogenicity -- toxicity -- treatment; HIV (Viruses) -- Treatment -- Periodicals; HIV (Viruses) -- Research -- Periodicals; 616.979206
• DOI: 10.2217/17584310.3.2.141
• Languages: English
• ISSNs: 1758-4310

Abstract

Evaluation of: Benhammou V, Warszawski J, Bellec S et al. : Incidence of cancer in children perinatally exposed to nucleoside reverse transcriptase inhibitors. AIDS 22, 2165––2177 (2008). The prevention of mother-to-child transmission of HIV hinges on administration of perinatal antiretroviral drugs, reducing transmission rates from 40 to less than 2%. The safety of short-term exposure to antiretroviral drugs in HIV-uninfected children is paramount to justify widespread implementation. Besides mitochondrial toxicity, lower birth weight and mild hematotoxicity, no major long-term adverse effects, such as teratogenicity, have been documented. Nucleoside inhibitors can potentially be embedded in the genetic material of fetuses. This genotoxicity may predispose HIV-uninfected children to cancers later in life. However, except for didanosine, no increase was measured in childhood cancer up to 5 years after exposure in a large French prospective cohort study, lending further support to the relative safety of short-term use of pre- and perinatal antiretroviral drugs. Nevertheless, the increased likelihood of rare cancers in the CNS after didanosine exposure warrants longer-term follow-up studies.