Absence of cardiac toxicity of zidovudine in infants
Absence of cardiac toxicity of zidovudine in infants
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DOI：
10.1056/nejm200009143431102
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发表时间：
2000-09-14
影响因子：
158.5
通讯作者：
Colan, SD
中科院分区：
文献类型：
--
作者：
Lipshultz, SE;Easley, KA;Colan, SD
背景：一些证据表明，围产期接触齐多夫定可能会导致婴儿心脏异常。我们前瞻性地研究了左心室的结构和功能，以确定是否有证据表明齐多夫定心脏毒性后，围产期exposure.Methods：我们遵循了一组出生的婴儿HIV感染的妇女从出生到5岁的超声心动图研究，每4至6个月。连续超声心动图获得了382名婴儿没有艾滋病毒感染（36齐多夫定暴露）和58名艾滋病毒感染的婴儿（12齐多夫定暴露）。重复测量分析被用来检查左心室结构和功能的四个措施，在第一个14个月的生活在齐多夫定exposure.Results：齐多夫定暴露与左心室平均缩短分数，舒张末期尺寸，收缩力，或质量在非HIV感染或HIV感染的婴儿显着异常。在未感染HIV的婴儿中，从未接触过齐多夫定的婴儿在10至14个月时的平均缩短分数为38.1%，接触过齐多夫定的婴儿为39.0%（平均差异，-0.9个百分点; 95%置信区间，-3.1至1.3个百分点; P=0.43）。在HIV感染的婴儿中，10至14个月的平均缩短分数在从未接触过齐多夫定的婴儿（35.4%）和接触过齐多夫定的婴儿（35.3%）中相似（平均差异，0.1个百分点; 95%置信区间，-3.7至3.9个百分点; P=0.95）。在出生后的前14个月内，齐多夫定暴露与缩短率降低（缩短25%或更少）没有显著相关。没有孩子超过10个月的年龄有抑郁分数shortening.Conclusions：齐多夫定是不相关的急性或慢性异常左心室结构或功能的婴儿暴露于药物在围产期。（N Engl J Med 2000;343：759-66.）(C)2000年，马萨诸塞州医学会。
Background: Some evidence suggests that perinatal exposure to zidovudine may cause cardiac abnormalities in infants. We prospectively studied left ventricular structure and function in infants born to mothers infected with the human immunodeficiency virus (HIV) in order to determine whether there was evidence of zidovudine cardiac toxicity after perinatal exposure.Methods: We followed a group of infants born to HIV-infected women from birth to five years of age with echocardiographic studies every four to six months. Serial echocardiograms were obtained for 382 infants without HIV infection (36 with zidovudine exposure) and 58 HIV-infected infants (12 with zidovudine exposure). Repeated-measures analysis was used to examine four measures of left ventricular structure and function during the first 14 months of life in relation to zidovudine exposure.Results: Zidovudine exposure was not associated with significant abnormalities in mean left ventricular fractional shortening, end-diastolic dimension, contractility, or mass in either non-HIV-infected or HIV-infected infants. Among infants without HIV infection, the mean fractional shortening at 10 to 14 months was 38.1 percent for those never exposed to zidovudine and 39.0 percent for those exposed to zidovudine (mean difference, -0.9 percentage point; 95 percent confidence interval, -3.1 to 1.3 percentage points; P=0.43). Among HIV-infected infants, the mean fractional shortening at 10 to 14 months was similar in those never exposed to zidovudine (35.4 percent) and those exposed to the drug (35.3 percent) (mean difference, 0.1 percentage point; 95 percent confidence interval, -3.7 to 3.9 percentage points; P=0.95). Zidovudine exposure was not significantly related to depressed fractional shortening (shortening of 25 percent or less) during the first 14 months of life. No child over the age of 10 months had depressed fractional shortening.Conclusions: Zidovudine was not associated with acute or chronic abnormalities in left ventricular structure or function in infants exposed to the drug in the perinatal period. (N Engl J Med 2000;343:759-66.) (C) 2000, Massachusetts Medical Society.