HIV Prevention Pill for Moms May Impair Cognitive Development in Kids

A recent study suggests that taking atazanavir during pregnancy to prevent the transmission of the HIV virus to their offspring may not be a good idea because the HIV prevention pill for moms may impair cognitive development in kids.

Researchers also found that the children of moms who took the drug while pregnant scored less in language tests and had problems related to social and emotional development later on. The kids’ scores were compared to those born to women who didn’t take the pill during pregnancy.

Atazanavir belongs to the protease inhibitor class of anitretroviral (ARV) drugs  and it is used to treat HIV infection and prevent further spread of the virus.

The study, which was published in the journal AIDS, involved over 1,000 babies and their HIV-positive mothers. Yet, none of the kids was diagnosed with HIV because their moms took the HIV prevention pill or were on other ARV medications before the kids were born.

After age 1, researchers were curious to learn whether the drug had any long-term effects on infant development. So, the research team used a standardized test on the babies to see if there were any developmental problems.

The team compared test results of 200 babies whose mothers took the drug with nearly 1,000 infants whose HIV-positive mothers underwent ARV therapy but they didn’t take the pill.

Tests showed that babies whose mothers were on atazanavir scored 3 pts lower than babies whose mothers stayed away from the drug. Babies exposed to atazanavir during pregnancy also scored lower than their peers in tests assessing social-emotional development.

Dr. Ellen C. Caniglia, lead author of the study and researcher with Harvard T.J. Chan School of Public Health, explained that the differences in development noted in the two groups of kids are not significant enough to trigger large clinical implications.

Nevertheless, kids born to HIV positive mothers already have a ‘constellation’ of risk factors that may later impair their cognitive and emotional development. So, the antiretroviral drug just adds one more risk factor on the list.

As a follow-up, researchers plan to learn whether development issues continue to affect the baby beyond age one, and whether other ARV drugs taken during pregnancy may interact with atazanavir, thus causing the problems in babies.

Fortunately, mother-to-child HIV transmission rates have dropped significantly in recent years due to retroviral therapy. In the U.S., fewer than 200 infants contract the virus from their mothers at birth.

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