Effect of highly active antiretroviral therapy on growth and development of infants and children

Abstract

Objective To investigate the effect of high active antiretroviral therapy (HAART) on growth and development of infants born to pregnant women infected with human immunodeficiency virus (HIV) and the effect on blocking mother to children transmission. Methods Totally 165 pregnant women diagnosed with HIV infection from May 2006 to May 2017 and their 169 infants, including four pairs of twins were enrolled, and 82 infants born to HIV negative pregnant women in the same period were enrolled as control. All of the pregnant women in the experimental group were administrated with HAART when HIV antibody test was positive. The delivery intervention and artificial feeding were carried out as well. The weight, height, hemoglobin (Hb), serum iron and serum calcium level of infants at birth, 12 months and six years old were monitored and compared between the two groups. Apgar scores of newborns and intelligence tests at six-year-old were also recorded. Statistical analysis was performed by t test. Results Pregnant women were generally in good conditions and well tolerated to the drugs. There were no significant differences in neonatal Apgar scores, body weight, body length, Hb, serum iron, serum calcium and CD4+ T lymphocyte count between HIV positive experimental group and control group (t =-1.27, -1.12, -3.41, -5.62, -0.89, -3.02 and-0.74, respectively, all P>0.05). At the age of 12 months, there were no significant differences in body weight, length, Hb, serum iron, serum calcium and CD4+ T lymphocyte count between the two groups (t = 1.02, 1.41, 1.32, 1.03, 0.89 and 1.06, respectively, all P > 0.05). At the age of six years, there were no significant differences in all indexes between the two groups (t= 1.02, 0.87, 1.58, 1.03, 0.92 and 2.07, respectively, all P > 0.05). Intelligence assessment was performed in 78 children of the experimental group and 45 children of the control group at the age of six years, and there was no significant difference between the two groups ((89.7±12.5) score vs (91.2±13.7) score, t=1.67, P=0.43). All the children in the experimental group were positive for HIV antibody at birth, and six cases were positive for HIV RNA who were diagnosed with neonatal HIV infection. HAART was initiated for the six cases, while HIV antibody tests were still positive until the age of 18 months after HAART. The rest of the children′s HIV antibody tests became negative with the mother to children tramsission rate of 3.55% (6/169). Conclusion HAART could not only block mother to children tramsission of HIV, but also has no effect on growth and intellectual development of children during the observation period. Key words: Antiretroviral therapy, highly active; Human immunodeficiency virus; Child; Growth and development