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Prevalence of neural tube defects in HIV-exposed pregnancies

The prevalence of neural tube defects (NTDs) is 7.0 per 10,000 live births in HIV-exposed pregnancies, which is similar to the prevalence in the general population, Medical Xpress reports research in the US Centres for Disease Control and Prevention Morbidity and Mortality Weekly Report has shown.

Dr Jennita Reefhuis, from the CDC in Atlanta, and colleagues estimated the overall prevalence of NTDs and prevalence of NTDs in HIV-exposed pregnancies during 2013 to 2017 for 15 jurisdictions using linked data from two CDC surveillance programmes for HIV/Aids and birth defects.

The researchers found that among women with diagnosed HIV infection, the prevalence of NTDs was 7.0 per 10,000 live births. This prevalence was similar to that in the general population from these 15 jurisdictions (7.0 per 10,000 live births) and the US estimated prevalence based on data from 24 states (approximately 8 per 10,000 live births).

"Continued efforts to collect information on pregnancies affected by maternal HIV infection are needed to understand the association between HIV treatment and birth defects and other pregnancy outcomes," the authors write.

Abstract
What is already known about this topic: In 2018, an association between periconceptional dolutegravir exposure and neural tube defects (NTD) was reported in Botswana. Data from U.S. birth defects and human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) surveillance programs had not previously been linked to assess NTD prevalence in births to women with HIV.

What is added by this report: Linking of data from birth defects and HIV/AIDS surveillance programs in 15 jurisdictions was done for the first time. The NTD prevalence in HIV-exposed pregnancies during 2013–2017 was estimated to be 7.0 per 10,000 live births, similar to the prevalence in the general population in the 15 jurisdictions and the U.S. estimate.
What are the implications for public health practice: Current US recommendations state that dolutegravir is a preferred antiretroviral drug throughout pregnancy (with provider-patient counseling) and an alternative antiretroviral drug in women who are trying to conceive. Although no difference in NTD prevalence in HIV-exposed pregnancies was found, data on the use of integrase strand transfer inhibitors in pregnancy are needed to understand the safety and risks of these drugs during pregnancy.

Authors
Jennita Reefhuis; Lauren F FitzHarris; Kristen Mahle Gray; Steven Nesheim; Sarah C Tinker; Jennifer Isenburg; Benjamin T Laffoon; Joseph Lowry; Karalee Poschman; Janet D Cragan; Fay K Stephens; Jane E Fornoff; Cheryl A Ward; Tri Tran; Ashley E Hoover; Eirini Nestoridi; Laura Kersanske; Monika Piccardi; Morgan Boyer; Mary M Knapp; Abdel R Ibrahim; Marilyn L Browne; Bridget J Anderson; Dipal Shah; Nina E Forestieri; Jason Maxwell; Kimberlea W Hauser; Godwin U Obiri; Rachel Blumenfeld; Dana Higgins; Carla P Espinet; Bernardita López; Katherine Zielke; Latoya P Jackson; Charles Shumate; Kacey Russell; Margaret A Lamp

[link url="https://medicalxpress.com/news/2020-01-neural-tube-defect-prevalence-hiv-exposed.html"]Medical Xpress report[/link]

[link url="https://www.cdc.gov/mmwr/volumes/69/wr/mm6901a1.htm?s_cid=mm6901a1_w"]Abstract[/link]

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