Maternal antiretrovirals and hepatic enzyme, hematologic abnormalities among human immunodeficiency virus type 1-uninfected infants: the NISDI perinatal study.

The objectives were to assess hepatic enzyme (HE) and hematologic abnormalities among human immunodeficiency virus-1-uninfected infants according to maternal antiretroviral regimen during pregnancy. In a prospective cohort HE and hematologic values of human immunodeficiency virus-1-uninfected term infants with hospital discharge (HD) within 6 days after birth were evaluated. Maternal antiretroviral regimens were categorized as: 1 or 2 nucleoside reverse transcription inhibitors (NRTIs) highly active antiretroviral therapy (HAART)/protease inhibitor (PI) or HAART/non-NRTI. Among 503 infants 63% and 24% had HE and hemoglobin abnormalities respectively at HD. Most or all HE and hemoglobin abnormalities (96-100%) were grade 1 or 2. At HD infants with maternal HAART/PI or HAART/non-NRTI were more likely to have elevated HE [adjusted odds ratio (AOR): 1.9 2.4 respectively] compared with infants whose mothers received 1 or 2 NRTIs. Infants with maternal HAART/PI were less likely to have abnormal hemoglobin values at HD (AOR 0.5) when compared with those whose mothers received 1 or 2 NRTIs. Persistently abnormal hemoglobin and HE values decreased with time such that < 10% of infants had abnormalities at 6 months of age. Maternal receipt of HAART regimens was associated with an increased risk of HE abnormalities and maternal HAART/PI was associated with a lower risk of abnormal hemoglobin values at HD. Abnormalities of HE and hemoglobin were generally mild and transient. (authors)