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Incidence of cancer in children perinatally exposed to nucleoside reverse transcriptase inhibitors.
- Source :
-
AIDS (London, England) [AIDS] 2008 Oct 18; Vol. 22 (16), pp. 2165-77. - Publication Year :
- 2008
-
Abstract
- Context: Long-term studies of tolerance to perinatal exposure to antiretroviral nucleoside reverse transcriptase inhibitors are required, in view of the potential genotoxicity of some of these molecules.<br />Objective: To evaluate the incidence of cancers in uninfected children born to HIV-infected mothers.<br />Method: Cancers were detected in a nationwide prospective cohort of children born to HIV-infected mothers by standardized questionnaire during the prospective follow-up period of 2 years; thereafter, they were detected by spontaneous pharmacovigilance declaration and by crosschecking data with the national registries of childhood cancer. Standardized incidence ratio for incidence comparisons with general population.<br />Results: Ten cases of cancer were detected among the 9127 exposed HIV-uninfected children (median age: 5.4 years, 53 052 person-years of follow-up). The overall incidence did not differ significantly from that expected for the general population: 10 cases observed versus 8.9 and 9.6 expected depending on whether 1990-1999 or 2000-2004 national rates were used as reference [standardized incidence ratio of 1.1 (0.3-1.5) and 1.0 (0.5-1.9)]. Five cases of central nervous system cancer were observed (standardized incidence ratio of 3.1 [1.0-7.2] P = 0.05 and 2.4 [0.8-5.6], P = 0.12). The relative risk of cancer for children exposed to didanosine-lamivudine combination was higher than that for zidovudine monotherapy [hazard ratio: 13.6 (2.5-73.9)].<br />Conclusion: This study did not evidence an overall increase in cancer risk in nucleoside reverse transcriptase inhibitor exposed children until 5 years of age. Results suggesting associations with specific nucleoside reverse transcriptase inhibitor combinations need further investigations. A longer surveillance, including differential analysis of the different cancer sites and various nucleoside reverse transcriptase inhibitors administered is warranted.
- Subjects :
- Anti-HIV Agents therapeutic use
Child
Child, Preschool
Epidemiologic Methods
Female
France epidemiology
HIV Infections drug therapy
HIV Infections transmission
Humans
Infant
Infectious Disease Transmission, Vertical prevention & control
Male
Neoplasms epidemiology
Pregnancy
Pregnancy Complications, Infectious drug therapy
Reverse Transcriptase Inhibitors therapeutic use
Anti-HIV Agents adverse effects
HIV Infections prevention & control
HIV-1
Neoplasms chemically induced
Prenatal Exposure Delayed Effects
Reverse Transcriptase Inhibitors adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1473-5571
- Volume :
- 22
- Issue :
- 16
- Database :
- MEDLINE
- Journal :
- AIDS (London, England)
- Publication Type :
- Academic Journal
- Accession number :
- 18832880
- Full Text :
- https://doi.org/10.1097/QAD.0b013e328311d18b