Prevention of vertical transmission and side effects of antiretroviral therapy in children born to HIV-positive South Eastern area of Santiago, Chile: 15-years perspective

Antiretroviral therapy (ART) has shown to be an effective measure in decreasing HIV vertical transmission (VT). Nevertheless it is not free from adverse effects in the newborn: risk of prematurity low birth weight metabolic disorders among others. Despite the importance of the subject there are few national data that analyze the problem. We performed a retrospective analysis of a cohort of HIV positive mother/child binomial followed between 1995 and 2010. Ninety-four pregnancies and 96 children (2 twin pregnancies) were analyzed. The rate of VT was 2.1%. Adverse effects attributed to ART were found on 85.4% of the newborn; highlighting the presence of anemia (70.8%) and several metabolic disorders [elevated lactate without acidosis (29.2%) lactic acidosis (12.5%) hyperkalemia (14.6%) metabolic acidosis (9.4%)]. Maternal exposure to protease inhibitors proved to be an independent risk factor for the development of metabolic disorders in newborns (OR 0.15 [0.04-0.48] p < 0.01). In our series ART was effective in reducing the VT however exposed newborns showed a high frequency of adverse effects so it is advisable to implement programs for monitoring these patients to prevent sequelae.