醫(yī)學(xué)上,，在懷孕期間HIV感染的女性患者在使用抗逆轉(zhuǎn)錄病毒藥物,，是防止艾滋病通過(guò)母嬰傳播非常有效的措施。感染HIV的女性患者在接受抗逆轉(zhuǎn)錄病毒藥物治療后，母嬰途徑傳播艾滋病毒的風(fēng)險(xiǎn)從15~25%下降到1%以下。
唇腭裂是口腔頜面部最常見(jiàn)的先天性畸形,，平均每生700個(gè)嬰兒中就有1個(gè)患唇腭裂,。唇腭裂不僅嚴(yán)重影響面部美觀，還因口,、鼻腔相通,，直接影響發(fā)育，經(jīng)常招致上呼吸道感染,，并發(fā)中耳炎,。
雖然抗逆轉(zhuǎn)錄病毒藥物有防止艾滋病毒母嬰傳播的功效,，但目前發(fā)表在Cleft Palate Craniofac J上一項(xiàng)研究表明：抗逆轉(zhuǎn)錄病毒與唇腭裂之間有密切相關(guān)性,，抗逆轉(zhuǎn)錄病毒藥物可能會(huì)導(dǎo)致嬰兒出生缺陷如唇腭裂等。
該研究分析了FDA不良事件報(bào)告系統(tǒng)中近5年來(lái)藥物引發(fā)先天性缺陷的相關(guān)數(shù)據(jù),。研究結(jié)果證實(shí)：雖然抗逆轉(zhuǎn)錄病毒藥物能防止艾滋病通過(guò)母嬰傳播,，但這些懷孕的準(zhǔn)媽媽們的孩子在出生時(shí)經(jīng)常會(huì)帶有先天性疾病。
這項(xiàng)研究共發(fā)現(xiàn)在所有已上市的26個(gè)抗逆轉(zhuǎn)錄病毒藥物中,，有7個(gè)抗病毒藥物會(huì)導(dǎo)致嬰兒唇腭裂事件發(fā)生,。
但研究人員強(qiáng)調(diào)要確定抗逆轉(zhuǎn)錄病毒藥物與唇腭裂之間是否直接有關(guān)還要進(jìn)一步開(kāi)展研究。(生物谷 Bioon.com)
doi:10.1597/10-095
PMC:
PMID:
Antiretroviral Prophylaxis and the Risk of Cleft Lip and Palate: Preliminary Signal Detection in the Food and Drug Administration's Adverse Events Reporting System Database
Vassiliki M. Cartsos, D.M.D., M.S.D., Pinelopi Kleio Palaska, D.M.D., Athanasios I. Zavras, D.M.D., M.S., Dr.MSc.
Objective: Antiretroviral prophylaxis has been found to be effective in preventing vertical HIV transmission to the offspring of infected mothers. Because medicine and the art of public health require benefits to outweigh any plausible risks, our study aimed to explore and quantify preliminary associations between antiretroviral medications and clefting.
Methods: We analyzed 5 years of available data from the Food and Drug Administration's Adverse Events Reporting System (Medwatch program) and calculated reporting odds ratios (RORs) and their associated 95% confidence intervals (CIs).
Results: The medications with the highest effects were efavirenz with an ROR of 196 (95% CI, 86 to 447), lamivudine with an ROR of 60.2 (95% CI, 14.25 to 148), the combination abacavir sulfate/lamivudine/zidovudine with an ROR of 59.3, and nelfinavir with and ROR of 50.5, followed by nevirapine, lopinavir/ritonavir, and lamivudine/zidovudine.
Conclusion: Given the multifactorial etiology of cleft lip and palate, further studies are needed to assess the relative safety of antiretroviral prophylaxis and the specific conditions or potential synergies that might lead to the development of this defect.
