Document Detail


Birth defects following exposure to efavirenz-based antiretroviral therapy during pregnancy: a study at a regional South African hospital.
MedLine Citation:
PMID:  19864931     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To determine the prevalence and type of birth defects among infants following exposure to efavirenz-based antiretroviral therapy (EFV-based ART) during pregnancy.
METHODS: A Pregnancy Registry was established to enable prospective follow-up of women taking EFV-based ART. In women who conceived on EFV-based ART, EFV was switched with another drug if they presented during the first trimester but was continued if they presented at or after 14 weeks' gestation. Pregnant women needing lifelong ART were commenced on EFV-based ART from 14 weeks' gestation onwards. Infants were followed up for 6 weeks after birth.
RESULTS: Between January 2006 and December 2008, 623 ART-naive pregnant women initiated EFV-based ART in the second/third trimester and 195 women conceived on EFV-based ART. Birth defects were observed in 16 of 623 live births [2.6%; 95% confidence interval (CI) 1.5-4.2] and in six of 184 live births (3.3%; 95% CI 1.2-7.0) from women exposed to EFV in the second/third trimester and first trimester, respectively. The prevalence of birth defects was not significantly different between the first and second/third trimester EFV exposure (prevalence ratio 1.27; 95% CI 0.50-3.20; P = 0.301).
CONCLUSION: No significant increase in the prevalence of birth defects following exposure to EFV-based ART in the first trimester was observed in this cohort. However, the limited number of first trimester EFV-exposed infants precludes definitive conclusions on the teratogenicity or safety of EFV.
Authors:
Ebrahim Bera; Katrin McCausland; Roxaan Nonkwelo; Batembu Mgudlwa; Saji Chacko; Busiwe Majeke
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  AIDS (London, England)     Volume:  24     ISSN:  1473-5571     ISO Abbreviation:  AIDS     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2009-12-23     Completed Date:  2011-01-03     Revised Date:  2014-02-06    
Medline Journal Info:
Nlm Unique ID:  8710219     Medline TA:  AIDS     Country:  England    
Other Details:
Languages:  eng     Pagination:  283-9     Citation Subset:  IM; X    
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MeSH Terms
Descriptor/Qualifier:
Abnormalities, Drug-Induced / epidemiology*,  ultrasonography
Adult
Anti-HIV Agents / adverse effects*
Benzoxazines / adverse effects*
Female
HIV Infections / drug therapy*
Humans
Infant
Pregnancy
Pregnancy Complications, Infectious / drug therapy*
Pregnancy Trimesters
Prenatal Exposure Delayed Effects / chemically induced,  epidemiology
Prevalence
Prospective Studies
South Africa / epidemiology
Ultrasonography, Prenatal
Chemical
Reg. No./Substance:
0/Anti-HIV Agents; 0/Benzoxazines; JE6H2O27P8/efavirenz

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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