TDF in HIV-positive pregnant women does not impair infant growth

The use of tenofovir disoproxil fumarate (TDF) among pregnant women with HIV does not seem to be linked to infant transient rickets, growth impairment, or renal dysfunction, reports a recent Vietnam study.

Researchers conducted a prospective observational study with 63 pregnant women with HIV. Mothers were treated with regimens based on either TDF (n=53) or zidovudine (AZT group; n=10). Infant measurements—such as body length, weight, head circumference, liver function biomarkers, and radiographic wrist score—were measured at birth and at 3, 12, and 18 months of age.

None of the infants were born with perinatal complications or congenital abnormalities. Those born to mothers on AZT tended to be shorter than their TDF counterparts, but not significantly so (46.4 vs 49.2 cm; p=0.061). Head circumference was significantly smaller in AZT infants (32.5 vs 34.0 cm; p<0.001).

Two-way analysis of variance, however, showed that after adjusting for age, infants born to mothers on AZT tended to have significantly shorter body length (p=0.002), lower weight (p=0.047), and smaller head circumference (p=0.049) than their TDF comparators.

Serum levels of alkaline phosphatase were likewise significantly higher in the TDF group (p=0.007), while no significant between-group differences were reported for other biomarkers including serum creatinine, phosphorus, percentage of tubular reabsorption of phosphate, and urine-β2-microglobulin.

Radiographic wrist score, used to monitor for rickets, was also comparable between groups, regardless of age.

“TDF use by pregnant Vietnamese women was not associated with infant growth impediment, renal dysfunction, or nutritional rickets, although it correlated with mild maternal renal tubular dysfunction,” the researchers said.