Occurrance of Adverse Hematological Events at one and Six Weeks in infants following Perinatal Exposure to Antiretroviral Drugs for the prevention of Mother to Child transimission of VIV at UTH/ Musaku Mwenechanya

Abstract

Perinatal transmission of Human Immunodeflency Virus (HIV) from mother to her new born can be prevented in most cases using a combination of Antiretroviral drugs reducing the risk to less than one percent(l%). However despite the beneficial effects of these drugs, maternal-fetal transfer of these potentially toxic drugs during pregnancy is of increasing concern. Among other concerns, of note is adverse hematological events both in the short and long term and this remains largely unknown with contradictory findings in the few studies done The aim of this study was to document the short term hematological outcomes at one week and six weeks in infants perinatally exposed to Antiretroviral Drugs used for the prevention of Mother to Child Transmission of HIV at UTH, One hundred and thirty-nine HIV exposed but uninfected infants as Confirmed by DNA/PCR at six weeks, were prospectively followed up until six weeks of age. Perinatal transmission prophylaxis regimens comprised Zidovidine(AZT) based regimens and non-AZT based regimens. Blood counts and differentials were determined at one and six weeks and adverse hematological events were documented and compared with documented normal values. The main focus was to document hemoglobin, absolute neutrophil and platelet count indices at one and six weeks. Data was further analysed according whether maternal prophylaxis included AZT or another nucleoside reverse transcriptase inhibitor. The proportion of infants that were found to have anaemia was 13.5% at one week and this increased to 20.3% at 6weeks .This study found 13.5% and 21.3% of infants developed neutropenia at one and six weeks respectively and 0.06 and 0.1% of infants developed thrombocytopenia at one and six weeks respectively in preterm babies. In term babies the proportion of neutropenia increased from 13.5% at one week to 24.1% at six weeks while the proportion of thrombocytopenia reduced from 4.1% at one week to 3.5% at six weeks VIII

This study shows that a significant proportion of infants developed anaemia and neutropenia following prenatal and postnatal exposure to antiretroviral drugs However the proportion was less so with thrombocytopenia.