Exposure to HIV drug in the womb may increase risk of microcephaly, developmental delays in children

Children born to women on HIV therapy containing the drug efavirenz were 2 to 2.5 times more likely to have microcephaly compared to children born to women on regimens of other antiretroviral drugs, according to an analysis funded by NIH.

Children born to women on HIV therapy containing the drug efavirenz were 2 to 2.5 times more likely to have microcephaly compared to children born to women on regimens of other antiretroviral drugs, according to an analysis funded by NIH. The children with microcephaly also had a higher risk for developmental delays, compared to children with normal head size. "Our findings underlie the importance of having alternatives to combination therapy with efavirenz for pregnant women with HIV," said study author Rohan Hazra, MD, chief of the Maternal and Pediatric Infectious Disease Branch of NIH's Eunice Kennedy Shriver National Institute of Child Health and Human Development, which provided funding for the study. Researchers analyzed data from a follow-up study of more than 3,000 infants born to women on HIV therapy during pregnancy. Based on Nellhaus standards, children whose mothers were on regimens containing the drug efavirenz were more than twice as likely to have microcephaly, compared with children whose mothers were on other regimens. According to the combined Nellhaus-CDC standards, children exposed to efavirenz in the womb were around 2.5 times as likely to have microcephaly. Of the 141 children exposed to efavirenz in the womb, 14 (9.9%) had microcephaly, compared to 142 of 2,842 who were not exposed to efavirenz (5%). The researchers noted that exposure to all other types of HIV therapies was not associated with a higher risk of microcephaly.