Adverse Effects Of Antiretroviral Therapy In Preventing Of Mother To Child Transmission Of HIV

Objective To evaluate the adverse effects of antiretroviral therapy for preventing mother-to-child transmission of HIV. Methods l,Hemogram and hepatic study : using combination Zidovudine plus Nevirapine regimen or single-dose NVP regimen for HIV infected pregnant women and their babies. The hemogram results was assessed by normal value, rooting in the sixth edition of medical textbooks. Liver function abnormality was reflected mainly by alaninetransaminase(ALT) values, which were graded according to the "Division of Acquired Immunodeficiency Syndrome(AIDS) toxicity guidelines" for adults and children. 2,Drug resistance study : The inclusion criteria is having no prior antiretroviral therapy with plasma viral load greater than 1000 copies/ml.The reverse transcriptase sequences were analyed in "Stanford HIV Drug Resistance Database". Result 1. In hemogram and hepatic study, 61 HIV-infected pregnant women and 41 babies enrolled in combination antiretroviral therapy regimen finally. For mothers, anemia was checked out in 28.1% of pregnant women, lower than the first four weeks after dosing (p < 0.05),but recovering at labor time (p= 0.169 ).Among the subject of hepatic damage of grade one, none was in the first stage and 5.8% were in the third stage (p = 0.005 ). For infant, 22.2% of infants received antiretroviral therapy of PMTCT appeared hepatic damage on grade one and 9.8% was with mild anemia. 61 HIV-infected pregnant women and 37 babies enrolled in the single-dose Nevirapine regimen. For mothers, the prevalence of anemia was 28.9% in entering. Hepatic damage of grade one was zero at the begining, but 5.1% in the end.( t = 2.266, p = 0.023). For infant: 8.1% of infants had hepatic damage on grade one and 21.6% had mild anemia. There were no significant difference noted in pregnant postpartum and infants' hemogram and hepatic function between two regimen (p > 0.05) .2. In drug resistance study, A total of 108 blood samples from pregnant women ,after 3 months of labor,was collected.But only 46 were enrolled finally. Combination antiretroviral therapy regimen: genotypic antiretroviral drug resistance to reverse transcriptase inhibitors (RTIs) were founded in five cases, including one for nucleotides reverse transcriptase inhibitors and four for nonnucleotides reverse transcriptase inhibitors,one of which is potential low drug resistance.The mutation were T69S, K103R,V179T and V179D. V179D is the case of potential low drug resistance The Protease Inhibitors (PIs) are also founded,Including two for L33F,one for Q58E, three for A71V and two for A71T. Conclusion There are few adverse effects (hemogram, hepatotoxicity and drug resistance) mainly reflected by both regimens for pregnancies and their infants.