替诺福韦在怀孕期间母亲和胎儿的安全性的系统评价

StephenW

Safety of Tenofovir During Pregnancy for the Mother and Fetus: A Systematic Review

    Liming Wang1,
    Athena P. Kourtis2,
    Sascha Ellington2,
    Jennifer Legardy-Williams2, and
    Marc Bulterys1,3

- Author Affiliations

    1Global AIDS Program, US Centers for Disease Control and Prevention, Beijing, China
    2Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion
    3Division of Global HIV/AIDS, Center for Global Health, US Centers for Disease Control and Prevention, Atlanta, Georgia

    Correspondence: Athena P. Kourtis, MD, PhD, MPH, Women's Health and Fertility Branch, Division of Reproductive Health, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, MS-K34, Atlanta, GA 30341 ([email protected]).

Abstract

Tenofovir disoproxil fumarate (TDF) safety during pregnancy has important public health implications. This review summarizes TDF safety during pregnancy, focusing on pregnancy outcomes, congenital anomaly risk, and other potential toxicities on neonates. Although information is limited, TDF appears to be safe during pregnancy. In 6 studies of human immunodeficiency virus type 1 (and/or hepatitis B virus)–infected women receiving TDF during pregnancy, adverse events were mild to moderate; none were considered to be TDF-related. Five studies that followed in utero TDF-exposed infants showed no increased risk of growth or bone abnormalities. One study showed slightly lower infant height at age 1 year, but the significance is unclear. The Antiretroviral Pregnancy Registry database, with 1800 pregnancies exposed to TDF in the first trimester, does not indicate increased congenital anomaly risk with TDF exposure. More evidence collected prospectively, ideally with bone density measurements and randomized trial design, will be optimal to determine the effects of antenatal TDF exposure on children's health.
Key words

StephenW

富马酸替诺福韦（ TDF ）在怀孕期间的安全具有重要的公共卫生意义。本文综述了TDF在怀孕期间的安全，重点对妊娠结局，新生儿先天性异常的风险，和其他潜在的毒性。 TDF的信息是有限的，虽然在怀孕期间似乎是安全的。在研究人类免疫缺陷病毒1型（和/或乙肝病毒）感染的妇女在怀孕期间接受TDF ，不良事件为轻度至中度，没有被认为是TDF相关。 5研究，随后在子宫内TDF暴露的婴儿表现出没有增长或骨骼异常的风险增加。一项研究表明，稍微降低婴儿1岁时的身高，但意义尚不清楚。抗逆转录病毒妊娠登记数据库，与1800年怀孕，在第一孕期暴露于TDF ，并不表明先天性异常风险增加与TDF风险。前瞻性地收集更多的证据，最好与骨质密度测量和随机试验设计，将是最佳的确定产前TDF暴露对儿童健康的影响。

咬牙硬挺

影响一岁幼儿身高？还有别的吗

hunterpt

一项研究表明，稍微降低婴儿1岁时的身高，但意义尚不清楚。 －－－还没确定呢