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    Meconium Atazanavir Concentrations and Early Language Outcomes in HIV-Exposed, Uninfected Infants with Prenatal Atazanavir Exposure

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    Issue Date
    2015-06-01
    Author
    Himes, Sarah K.
    Huo, Yanling
    Siberry, George K.
    Williams, Paige L.
    Rice, Mabel L.
    Sirois, Patricia A.
    Frederick, Toni
    Hazra, Rohan
    Huestis, Marilyn A.
    Publisher
    Lippincott, Williams & Wilkins
    Type
    Article
    Article Version
    Scholarly/refereed, author accepted manuscript
    Rights
    Copyright © 2015 Wolters Kluwer Health, Inc.
    Metadata
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    Abstract
    OBJECTIVE: To investigate whether prenatal atazanavir (ATV) exposure, assessed by meconium antiretroviral quantification, predicts early child language outcomes. Prenatal ATV exposure previously was associated with poorer language development in one-year-olds. METHODS: Pregnant women with HIV and their uninfected infants enrolled in the SMARTT study. Meconium antiretroviral concentrations were quantified by liquid chromatography-tandem mass spectrometry. Language development at 1 year was assessed with MacArthur-Bates Communicative Development Inventory (CDI) and Bayley Scales of Infant and Toddler Development—Third Edition (Bayley-III). Late language emergence (LLE) was defined as ≥ one of four CDI scores ≤10th percentile for age. Associations between fetal ATV exposure timing and duration, meconium ATV concentration, and language outcomes were evaluated, adjusting for potential confounders. RESULTS: Through 2013, meconium samples were available from 175 of 432 infants with prenatal ATV exposure. Valid Bayley-III (n=93) and CDI (n=106) assessments also were available. After adjustment for potential confounders, higher ATV meconium concentrations were associated with lower LLE risk (P=0.04), and cumulative ATV exposure duration also was associated with higher Bayley-III Language scores (P=0.03). Maternal ATV duration and initiation week correlated with ATV meconium concentrations (positively and negatively, respectively). CONCLUSIONS: Higher meconium ATV concentrations were protective against developmental language delays at 1 year, suggesting the importance of fetal ATV detoxification into meconium. This information supports ATV exposure safety for infant language development. ATV is a preferred ARV for pregnant women with HIV, suggesting the importance of ATV safety investigations. Additionally, further pursuit of the influences on language development in HEU infants is required.
    Description
    This is not the published version.
    URI
    http://hdl.handle.net/1808/24502
    DOI
    https://doi.org/10.1097/QAI.0000000000000558
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    • Speech-Language-Hearing Scholarly Works [75]
    Citation
    Himes, S. K., Huo, Y., Siberry, G. K., Williams, P. L., Rice, M. L., Sirois, P. A., … Huestis, M. A. (2015). Meconium Atazanavir Concentrations and Early Language Outcomes in HIV-Exposed, Uninfected Infants with Prenatal Atazanavir Exposure. Journal of Acquired Immune Deficiency Syndromes (1999), 69(2), 178–186. http://doi.org/10.1097/QAI.0000000000000558

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    Contact KU ScholarWorks
    785-864-8983
    KU Libraries
    1425 Jayhawk Blvd
    Lawrence, KS 66045
    785-864-8983

    KU Libraries
    1425 Jayhawk Blvd
    Lawrence, KS 66045
    Image Credits
     

     

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