Does Anti-HIV drug use during pregnancy affect child?
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I have recently settled a case where a failure to diagnose a pregnant woman's HIV status resulted in vertical transmission to her child. Unfortunately, neither received appropriate treatment until they where diagnosed many months later.
I was very interested to read a research article by the National Institute of Health saying that anti-HIV drug use during pregnancy does not affect infant size or birth weight. Intuitively, I expected such drugs to have an effect on the developing foetus. This research relates specifically to the anti-HIV drug tenofovir. However, on further reading; at 1 year of age, children born to the tenofovir-treated mothers were slightly shorter and had slightly smaller head circumference about 1 centimetre each, on average than were infants whose mothers did not take tenofovir.
"They found that mothers taking tenofovir in combination with other anti-HIV medications and mothers on anti-HIV drug combinations that did not include tenofovir gave birth to infants who were smaller, on average, than infants born to HIV-negative mothers. However, they did not find significant differences between infants from the two groups of HIV-positive mothers.
The tenofovir-exposed infant's smaller average size and head circumference at one year of age suggests tenofovir could have a delayed effect on growth. Further research on this and other classes of anti-HIV drugs is ongoing in the PHACS".
Anti-HIV drugs are used in pregnancy to prevent vertical transmission to the child as well as treating the mother. Therefore a balance needs to be struck between any risks of taking the medication and the risks of the child being born with HIV. If my recent client had been given the opportunity to take such medication; I am sure that she would have been happy to do so to prevent the lifetime of medication and worry that is inevitable due to her child's positive diagnosis.
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