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Atazanavir taken during pregnancy negatively impacts fetal development, according to a recent study which sheds light on the risks associated with this drug.
The findings were presented in the journal AIDS, following research conducted by Dr. Ellen C.Caniglia, affiliated with the Harvard T.J. Chan School of Public Health.
The purpose was to investigate the adverse reactions and complications experienced after taking atazanavir, an anti-retroviral drug which can be administered during pregnancy, so as to help avert HIV transmission between mother and child.
Prior research led by Harvard scientists indicated that babies delivered by HIV-positive women who take atazanavir tend to have a slightly higher risk of experiencing developmental problems, when compared against infants whose mothers haven’t used this type of medication.
Given the fact that the danger was considered minimal at the time, atazanavir was prescribed as before even to pregnant women, and guidelines regarding dosage weren’t revised in any way.
However, it appears that everything might have to change now that a more extensive trial proved once again that the anti-retroviral drug may be harmful to fetal development.
The investigation, based on data collected during the Pediatric HIV/Aids Cohort Study, included 167 female patients who followed treatment based on atazanavir while pregnant.
Also taking part in this research were 750 other expectant mothers, who favored other types of preemptive therapy instead, and didn’t take this type of medication despite being HIV-positive.
A follow-up examination was conducted once the babies delivered by the initial subjects turned one, in order to identify potential developmental delays, affecting various aspects of the the children’s lives.
By assessing each baby based on the Bayley Scales of Infant and Toddler Development (Third Edition), it was determined that kids whose mothers had taken atazanavir during pregnancy fared worse at language development tests than other babies who weren’t exposed to this protease inhibitor while in the womb.
Namely, their results were approximately 3 points lower than those obtained by their counterparts, and the correlation persisted no matter what trimester of pregnancy was chosen for the debut of the HIV prevention treatment.
Babies that had contact with atazanavir in utero were also proven to have more trouble expressing and handling their feelings, or when it came to starting and maintaining satisfying relationships.
Overall, their socio-emotional development lagged approximately 5 points behind that of other children whose mothers hadn’t required atazanavir during gestation.
It must be noted that this correlation was encountered especially among infants who were exposed to the HIV prevention medicine throughout the second and third trimester of pregnancy, without being detected following such treatment administered in the first trimester.
On the other hand, detrimental effects of atazanavir weren’t reported when taking into account the babies’ cognitive development (ability to learn, recall information, take decisions or solve problems), motor skills (ability to move one’s body with ease and precision), and adaptive skills (ability to complete basic, everyday tasks).
Even though there aren’t major developmental disparities between children exposed to atazanavir and others who haven’t had this environmental factor to deal with while in the womb, study authors still believe small changes should also be acknowledged, because their impact might become more far-reaching than we might suspect at first.
According to them, further research should be carried out, in order to examine this association more carefully, and verify if development delays actually occur due to another drug called tenofovir disoproxil, which is frequently administered alongside atazanavir.
Fetal development has already been proven to be affected by numerous other external forces, like certain viral infections (Toxoplasma, rubella, herpes, cytomegalovirus etc.), psychoactive drugs (tobacco, alcohol, heroin, cocaine etc.), and commonly prescribed medication (thalidomide in the 1960’s, or anti-epileptics, anticoagulants or hormone replacements nowadays).
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