Children who were exposed to HIV in the womb whose mothers received anti-HIV medications during pregnancy were no more likely to show language delays by age two than HIV-exposed children whose mothers were not treated during pregnancy, according to a study by University of Kansas Distinguished Professor Mabel L. Rice with researchers at the National Institutes of Health (NIH) and other universities.
The findings allay concerns in the medical community that the typical anti-HIV drug combinations could affect the developing fetal brain in ways that cause language delays.
In both groups, about 25 percent of the children had language delays by two years of age, suggesting that the delays were not associated with anti-HIV drugs taken during pregnancy. These combination treatments usually include three or more drugs from at least two drug classes.
For a woman who is HIV-positive and pregnant, recommended combination therapies treat the infection and greatly reduce the chance that the virus will spread to the fetus. Previous studies suggested that the drugs used to treat pregnant women might contribute to language delays in infants and toddlers, even those who remained HIV-negative.
However, the researchers concluded that one drug sometimes used in the combination treatments should be monitored. Children whose mothers received combination therapy containing the drug atazanavir were more likely to have language delays at one year of age than were the other children in the study. But these children appeared to catch up to their peers by age two.
"We continue to investigate the sources of risk for language delays in children exposed to HIV in the womb. In clinical practice it is prudent to monitor these children for signs of language delay, "said Rice.
The researchers evaluated the language skills of nearly 800 children for the study that is part of a national collaboration between several NIH institutes and universities called the Pediatric HIV/AIDS Cohort Study or PHACS. PHACS began in 2005 to address critical pediatric HIV issues on the long-term safety of fetal and infant exposure to antiretroviral therapy and the effects of HIV infection acquired in womb in adolescents.
Rice, the Fred and Virginia Merrill Distinguished Professor of Advanced Studies at KU, was the lead investigator in a previous PHACS study that found that children exposed to HIV at birth are at risk for language impairments. Rice is an international authority on language disorders in children and the genetics of language acquisition.
- Rice, Mabel L.; Zeldow, Bret; Siberry, George K.; Purswani, Murli; Malee, Kathleen; Hoffman, Howard J.; Frederick, Toni; Buchanan, Ashley; Sirois, Patricia A.; Allison, Susannah M.; Williams, Paige L; for the Pediatric HIVAIDS Cohort Study (PHACS). Evaluation of Risk for Late Language Emergence after In Utero Antiretroviral Drug Exposure in HIV-Exposed Uninfected Infants. Pediatric Infectious Disease Journal, 15 May 2013 DOI: 10.1097/INF.0b013e31829b80ee
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