Important note: Information in this article was accurate in January 1999. The state of the art may have changed since the publication date.AIDSWEEKLY Plus; Monday, January 25, 1999
Daniel J. DeNoon, Senior Editor
The finding strengthens current recommendations that all pregnant women with HIV infection receive AZT during pregnancy. These recommendations are based on the findings of the Pediatric AIDS Clinical Trials Group (PACTG) 076 study, which showed that such AZT use dramatically decreases mother-to-infant HIV transmission.
Mary Culnane and colleagues of the PACTG 219/O76 Teams followed 234 HIV children born to 230 HIV infected women enrolled in Protocol 076 and followed through February 28, 1997 in Protocol 219. None of the children acquired HIV infection; 122 were born to women who received AZT and 112 were born to women who received placebo.
"No adverse effects were observed in HIV uninfected children with in utero and neonatal exposure to zidovudine followed up for as long as 5.6 years," they reported in the Journal of the American Medical Association ("Lack of Long-Term Effects of In Utero Exposure to Zidovudine among Uninfected Children Born to HIV Infected Women," JAMA, 1999;281:151-7).
The median age of the children at last follow-up was 4.2 years (range, 3.2 to 5.6 years). There were no differences between the two groups of children in terms of sequential measurements of lymphocyte subsets; z scores based on weight, height, and head circumference; and cognitive/developmental function.
None of the children died or developed malignancies. Two of the AZT-exposed children developed unexplained abnormal ophthalmic findings. An additional AZT-exposed child had a mild cardiomyopathy on an echocardiogram performed at age 48 months but remains asymptomatic.
"Continued prospective evaluations of children born to HIV infected women who are exposed to antiretroviral or immunotherapeutic agents are critical to assess the long-term safety of interventions that prevent perinatal HIV transmission," Culnane et al. advised.
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