Cancer not a risk for kids exposed to HIV drugs
Children born to women on antiretroviral therapy for HIV but who escaped infection themselves do not appear to have any greater risk of cancer than children in the general populatio.
WASHINGTON – Children born to women on antiretroviral therapy for HIV but who escaped infection themselves did not appear to have any greater risk of cancer than children in the general population, researchers reported here.
Of 2,721 children in a New Jersey database who were exposed to antiretroviral therapy -- either because their mothers took the drugs during pregnancy or the children received them after birth or were exposed to them through breastfeeding -- only four cases of cancer were detected, according to Wade Ivy III, PhD, an epidemiologist in the Division of HIV/AIDS Prevention at CDC in Atlanta, and colleagues.
That rate that did not differ statistically from the rate among other children in New Jersey or in the U.S.
"Observed cancer incidence among prenatally antiretroviral-exposed individuals did not differ significantly from cases expected based on state (2.9; standard incidence ratio [SIR]=1.04; 95% CI 0.22 to 3.05) and national (2.6; SIR=1.14; 95% CI 0.24 to 3.34) reference rates," they reported.
At his poster presentation at the International AIDS Conference, Ivy told MedPage Today, "We found no evidence of an increased cancer risk among those exposed to antiretroviral medication prenatally, intrapartum, or postnatally."
He said that 81% or 1,873 children for whom data were available had mothers who took antiretrovirals during pregnancy; such a regimen had been recommended by the CDC since 1994 to combat mother-to-child-transmission of HIV. He also noted that 1,876 children (81%) had been exposed to the drugs during the perinatal period, and 2,283 children (98%) had received the drugs during infancy.
"Based on what we found in our analysis, we have no basis to suggest there is an increased cancer risk among children who are exposed to antiretrovirals in utero or perinatally," Ivy said.
By cross-referencing two databases, Ivy and colleagues were able to identify 3,421 children whose mothers took the drugs during pregnancy. Of those children 3,085 were delivered without evidence of virus infection. Information on the use of antiretrovirals in mothers and babies was available for 2,721 of these uninfected children.
Ivy said that all four of the children diagnosed with cancer survived. One 7-year-old boy was diagnosed with Hodgkin's nodular sclerosis. He is now 14. Another boy was diagnosed with acute myeloid leukemia before age 1. He is now 13.
A third boy was diagnosed with hepatocarcinoma at age 5. He is now 11. A 2-year-old girl was diagnosed with pleuropulmonary blastoma. She is now 9 years old. The girl was not exposed to antiretrovirals perinatally.
"This is really important information," Sharon Nachman, MD, director of pediatric infectious diseases at Stony Brook University School of Medicine in New York, told MedPage Today. "There is always that lingering question in people's minds: Now that we are giving out so many antiretrovirals to women before they are pregnant, during their pregnancy, and exposing those babies to it, are we going to see any signal of any damage from those medications?"
"The good news from this study in New Jersey, which followed lots of children, is that they didn't see any signal. It tells the rest of us who are putting all those families and mothers on medication that cancer in their children is not a worry," Nachman said. "There are old data that said there was no signal, and this information says, 'That is correct. There is no signal.'"
Ivy and Nachman had no disclosures.
By Ed Susman
Primary source: International AIDS Conference Source reference: Ivy III W, et al "Cancer among children with perinatal exposure to HIV and antiretroviral medications -- New Jersey, 1995-2010" IAC 2012; Abstract
Source: MedPage Today