Abstract
Infant antiretroviral (ARV) prophylaxis given to children who are human immunodeficiency virus (HIV)-exposed but uninfected (CHEU) to prevent HIV transmission through breastfeeding previously proved its efficacy in the fight against the pediatric epidemic. However, few studies have investigated the short- and long-term safety of prophylactic regimens. We previously reported a decrease of mitochondrial DNA (mtDNA) content among CHEU who received one year of lamivudine (3TC) or lopinavir-boosted ritonavir (LPV/r) as infant prophylaxis. We aimed to describe mtDNA content at six years of age among these CHEU, including those for whom we identified mtDNA depletion at week 50 (decrease superior or equal to 50% from baseline), and to compare the two prophylactic drugs. We also addressed the association between mtDNA depletion at week 50 with growth, clinical, and neuropsychological outcomes at year 6. Quantitative PCR was used to measure mtDNA content in whole blood of CHEU seven days after birth, at week 50, and at year 6. Among CHEU with identified mtDNA depletion at week 50 (n = 17), only one had a persistent mtDNA content decrease at year 6. No difference between prophylactic drugs was observed. mtDNA depletion was not associated with growth, clinical, or neuropsychological outcomes at year 6. This study brought reassuring data concerning the safety of infant 3TC or LPV/r prophylaxis.
Highlights
In 2019, pediatric human immunodeficiency virus (HIV) infections accounted for about 9% of all new HIV infections worldwide, 90% of which were in sub-Saharan African countries [1]
AIDS Free.” program, postnatal transmission of HIV accounted for 46% of new HIV infections in infants among 21 priority countries defined by the WHO in 2011 [2]
We addressed the association between mitochondrial DNA (mtDNA) depletion at week 50 and growth, clinical, and neuropsychological outcomes at year 6
Summary
In 2019, pediatric human immunodeficiency virus (HIV) infections accounted for about 9% of all new HIV infections worldwide, 90% of which were in sub-Saharan African countries [1]. AIDS Free.” program, postnatal transmission of HIV accounted for 46% of new HIV infections in infants among 21 priority countries defined by the WHO in 2011 [2]. HIV transmission to infants during breastfeeding is mainly explained by the lack of adherence to the maternal antiretroviral (ARV) treatment or the absence of treatment [2,3]. Considerable progress in accessing viral load and antiretroviral therapy has been made in many countries, with 85% of HIV pregnant women receiving ARV, efforts need to be reinforced in order to achieve the elimination of all postnatal transmission by 2030 [1]
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